The Australian Aged Care Quality and Safety Commission has released its latest report providing valuable insights into the performance of providers in the aged care sector from 1 October to 31 December 2022 (Q2). The report draws on a range of information collected through the Commission's activities, including accrediting and monitoring services, resolving complaints, and ensuring compliance with legislated responsibilities. 

The purpose of this report is to evaluate and treat risks to the health, safety, and wellbeing of older Australians by providing information and data that reflect the Commission's commitment. The report also highlights regulatory reforms, including the expansion of the Serious Incident Response Scheme (SIRS) and the introduction of a new Code of Conduct for Aged Care workforce. In addition, the report discusses changes to administration and management charges that affect home care packages, which came into effect on 1 January 2023. This article will provide an overview of the report's key findings and discuss its implications for the aged care sector. 

Tunstall Healthcare stays up-to-date on major industry news and updates, such as the Aged Care Sector Report, to ensure we're in tune with the sector's most pressing needs and able to deliver world-class care solutions that best suit our clients' needs.

Read the full report here: https://www.agedcarequality.gov.au/media/94463 

Residential care services vs home services in Australia

The report includes a breakdown of residential care and home services in Australia. Aged care services typically refer to home care services that help older people live independently in their own homes, while residential care services involve care provided in a residential aged care facility. Home services include Home Care Packages (HCP), Commonwealth Home Support Programme (CHSP) services, flexible care and services delivered in a home setting.

As of Q4 2022, there were 2,244 home care services and 2,664 residential aged care services in Australia. The number and distribution of these services varied by state, as indicated by the infographic below:

Source: Aged Care Quality and Safety Commission

Aged care consumers breakdown

This data provides a breakdown of the number of aged care consumers in Australia, based on the type of care they receive. The figures show that there are currently:

• 188,877 individuals receiving residential care

• 249,429 individuals receiving Home Care Packages

• 818,228 individuals receiving support through the Commonwealth Home Support Programme

This information is important in understanding the overall landscape of aged care services in Australia and the specific needs of different groups of consumers.

Source: Aged Care Quality and Safety Commission

Reportable incidents in aged care

The report provides a breakdown of reportable incidents in aged care services during Q4 2022. These incidents are defined as "any untoward event or circumstance that causes harm, or increases the risk of harm, to an aged care service user."

In terms of reportable incidents, there were 12,106 reportable incidents in residential aged care services and in Oct-Dec 2022. The most common types of reportable incidents were: (brackets indicate number of reportable incidents per type)

• Unreasonable use of force (7,663)

• Neglect (1,844)

• Psychological or emotional abuse (1,023)

Source: Aged Care Quality and Safety Commission

Unreasonable use of force insights

The most common reportable incident notification in Q2 was unreasonable use of force, accounting for over six out of every 10 incidents reported to the Commission since the inception of the Serious Incident Response Scheme (SIRS). A SIRS Case Study Insights Report on Unreasonable Use of Force will be published to help providers improve their response to such incidents, focusing on incidents where residents use force on other residents, which account for 86% of these incidents. However, close to 1 in 10 incidents involve staff using force on residents, which will be the focus of a separate insights report by the Commission to consider causes, risk factors, and prevention measures.

Monitoring Serious Incident Response Scheme notification rates

The Serious Incident Response Scheme (SIRS) is monitored by the Commission to identify trends in the aged care sector and target its education and engagement initiatives towards high-risk areas. One method of monitoring is to examine the rate of notified serious incidents over a specific period and track any changes from quarter to quarter. This rate reflects the number of incidents reported in the context of all residential care delivered, allowing the Commission to focus its regulatory activity on services with concerning reportable incident rates. 

Providers can use this information to compare their rate of reportable incidents to others and improve their Incident Management System and service governance. It's important to note that the number of serious incident notifications doesn't necessarily indicate the number of instances of harm to an aged care recipient, as reports may include multiple notifications of the same matter, allegations of incidents, or situations where incidents occurred but injury was avoided. 

As provider capabilities improve, the Commission expects to see a decline in the rate of incidents, indicating an overall improvement in care and incident prevention.

Sector performance against Aged Care Quality Guidelines

The report evaluates the performance of the aged care sector against the Aged Care Quality Guidelines, which are designed to ensure that aged care services are safe, effective, and meet the needs of consumers. High-level summary of Q1 vs Q2 performance provided below:

Number of aged care services:

Q1: 4,882

Q2: 4,908

On-site quality assessment and monitoring site visits:

Q1: 878

Q2: 760

Services where non-compliance was found against at least one Quality Standard:

Q1: 241

Q2: 178

Source: Aged Care Quality and Safety Commission

Based on the data provided, it appears that the number of aged care services increased slightly from Q1 to Q2. However, the number of on-site quality assessment and monitoring site visits decreased from Q1 to Q2. On a positive note, the number of services where non-compliance was found against at least one Quality Standard decreased from Q1 to Q2 - with a 1.91% increase in the number of compliant aged care services from Q1 to Q2. This could suggest that aged care services are making progress towards meeting the Aged Care Quality Guidelines. However, continued monitoring and improvement efforts are necessary to ensure that all services meet these important standards.

Complaints in residential care

The report provides a definition of a complaint in the context of residential care services. A complaint is defined as "an expression of dissatisfaction by a care recipient, their representative, or another person, regarding the service or care provided by an aged care service." 

As the Commission themselves highlight:

“It is important to note that low or high complaint numbers are not, by themselves, a measure of good or poor service delivery. A service with a positive complaints culture will encourage feedback and use it as an opportunity to improve service delivery. Therefore, the Commission is working to improve consumer confidence in raising concerns or complaints with providers directly or with the Commission, or both.”

Total number of complaints

In Q2 2022, the Commission received 1,261 complaints about residential aged care services; a 3.1% increase from the previous reporting period.

Complaints distribution by state/territory 

A breakdown of complaints made in each state and territory can be seen in the table below:

Source: Aged Care Quality and Safety Commission

In terms of the types of complaints received, the report states that the most common complaints were related to:

Top 10 complaint issues:

• Personnel number/sufficiency - 153

• Medication administration and management - 149

• Personal and oral hygiene - 142

• Falls prevention and post fall management - 132

• Representative/family consultation - 92

• Change of clinical status/deterioration - 90

• Health Care – wound management - 89

• Consistent client care and coordination - 84

• Physical environment – cleanliness - 77

• Lack of consultation/communication - 76

The number next to each complaint indicates the number of complaints for each complaint/issue type.

Concerns about the number/sufficiency of residential care personnel was the number

one issue in complaints this quarter, followed by medication administration and management, and personal and oral hygiene. The quality and variety of food and catering fell out of the top 10 issues this quarter, while consistent client care and coordination, and wound management appeared in the top 10.

Complaints by complainant group and issue type

The report also provides a breakdown of the complaints received by the Commission about residential care by who made them. Representatives or family members made the most complaints about residential care services (55%), while consumers of those services made the least (12.5%). Family members were most likely to complain about falls prevention and post-fall management, and medication management. Complaints about personnel were more likely to be made anonymously.

Complaints were also segmented by type + complainant group; see the diagram below and the full report for more information:

Source: Aged Care Quality and Safety Commission

Finalised complaints

Residential care

In Q2 2022, the Commission finalised a total of 1,303 residential care complaints, which is the sum of complaints addressed through the early resolution pathway and the formal resolution process. Of these, 1,236 complaints involving 3,164 issues were resolved through the early resolution pathway, while 67 complex complaints involving 234 issues were addressed through formal resolution processes such as conciliation, mediation, formal investigation, or requiring the provider to resolve the issue within a set timeframe. 

Home services

This quarter, there were over one million consumers of home services, comprising 249,429 recipients of home care packages (HCP) and 818,228 recipients of Commonwealth Home Support Programme services. The Commission received 948 complaints about home services, of which 829 were about home care packages at a rate of 0.33 complaints per 100 HCP consumers. The total number of complaints and rate of complaints has remained relatively stable compared with last quarter.

It's worth noting that while complaints are an important way for care recipients and their representatives to provide feedback on the quality of care and services provided by aged care services, they only represent a small portion of the overall experiences of those receiving care. The Commission encourages care recipients and their representatives to provide feedback in other ways, such as through regular meetings with the service provider or by completing surveys.

Conclusion

Overall, the Q2 2022 report from the Aged Care Quality and Safety Commission provides valuable insights into the performance of aged care services in Australia. The data on complaints in residential care highlights the importance of ensuring that care recipients and their representatives have avenues for providing feedback on the quality of care and services provided, and the need for service providers to respond promptly and effectively to complaints. The report also underscores the ongoing need for a strong focus on quality and safety in the aged care sector.

As an organisation that is passionate about helping people regardless of their location, age or ability, Tunstall is committed to working with aged care providers and individuals to deliver the very best service for older people. To find out more about how we’re contributing to helping people live more independently in their golden years, visit our website or contact us to learn about our Connected Healthcare solutions.

Read the full report here: https://www.agedcarequality.gov.au/media/94463