A key element of the aged care reform agenda is a new Aged Care Act and a set of strengthened standards which are proposed to take effect from 1 July 2024, designed to place older people at the front and centre of care planning and delivery, with greater protections.
The initial draft of the revised Standards underwent wide consultation along with a pilot involving a variety of providers, resulting in a final draft being released in December 2023.
While the final wording is subject to passage of the Aged Care Act through Parliament, the Aged Care Quality and Safety Commission has indicated any further changes are expected to be minor.
Analysis of the final draft indicated a large proportion of the proposed new Actions are aligned to, or expand on, requirements under the current Standards.
In addition, some obligations from other instruments such as the Quality of Care and User Rights Principles have been included.
The explicit and detailed nature of these Actions provide greater clarity for providers but are likely to require a review of practices, updates to policies and procedures, and additional staff training.
Standard 1: The Person
The older person is at the centre of the strengthened Standards with the required Actions and themes of Standard 1 flowing through to all other Standards.
This results in a more detailed focus on delivering service that is structured around the needs, preferences and choices of each person.
Language throughout the Standards including changed terminology from ‘consumer’ to ‘older person’ demonstrates that people in aged care should be considered active partners in their own care rather than being a recipient of a service.
It introduces new concepts of ‘trauma aware’ and ‘healing informed’ care and stronger requirements on understanding communication needs, transparency in agreements, fees and invoicing, informed consent and supported decision-making.
Standard 2: The Organisation
While Standard 2 aligns with many of the current requirements it has expanded expectations that include:
■ partnering with older persons in the design and improvement of care and services
■ business and strategic planning including for the workforce
■ key systems including quality, risk, incident and information management
■ engagement with and support for the workforce including maintaining psychological safety
■ competency-based training on specified topics
■ emergency and disaster management.
Standard 3: The Care and Services
Similarly, this Standard replicates and builds on existing requirements.
Meeting the specific needs of people living with dementia using evidence-based practice and building on their strengths is a feature along with a focus on reablement and maintaining function for all older people.
Other changes include:
■ specified events that will trigger a review of care and services plans
■ expanded requirements for advance care planning
■ support for workers to recognise and respond to risks and identify deterioration
■ involving older people in selecting their workers
■ effective communication including non-verbal communication
■ having connections with specialist dementia care services.
Standard 4: The Environment
Current requirements have been expanded to include:
■ separating the Actions for residential vs home care settings
■ specifying that the residential care environment is fit for purpose, accessible for people with a disability and has safety risks ‘unobtrusively’ reduced
■ detailed actions for infection prevention and control that align with regulations (e.g. the need for an Infection Prevention and Control Lead).
Standard 5: Clinical Care
This Standard contains new and enhanced requirements which mirror many of those in the National Safety and Quality Health Service Standards such as:
■ specific obligations relating to clinical governance including the role of the governing body, workforce capability and new actions to implement a digital clinical information system
■ detailed and specific actions that focus on managing key risk areas of swallowing, continence, mobility, nutrition and hydration, mental health, pain, oral health, pressure injuries and wounds, sensory loss, cognitive impairment and palliative and end-of-life care
■ ensuring care is comprehensive and co-ordinated.
Standard 6: Food and Nutrition
Food and nutrition are a particular focus with a dedicated standard (applicable to residential care providers only) covering the dining experience and the older person’s sense of choice, involvement and enjoyment of mealtimes as well as the food and drink provided.
This Standard requires a partnership with older people in developing menus and increasing their sense of choice on the food and drink available to them, reflecting broader themes across the revised Standards.
Standard 7: The Residential Community
This standard will also only apply to residential care services. Key changes include:
■ providing lifestyle and activities with a new action to minimise boredom and loneliness
■ an increased focus on psychological safety, choice and control over who enters the person’s room, including when entertaining visitors in private
■ managing transitions between care services.
ACCPA has many options to help you prepare for these changes, from free advice to tailored consultancy. ACCPA also provides system solutions for safety, quality and compliance management giving providers a helping hand to compliance with the new standards, whether ACCPA members or not.
Amanda Allen, Head of Services, Aged & Community Care Providers Association