If you are working in the aged care sector, you will definitely know that this week marks the start of some pretty big changes to how the Australian Aged Care Quality Agency works, and to the quality standards they will be auditing under. First of all it's now unannounced visits all the time for residential care facilities - this is massive and I believe we will see a big increase in the number of not mets being issued for at least the first 12 - 18 months of this new methodology.
The other big change is the merging of all the different aged care standards into one set called the Aged Care Quality Standards. This will affect every Home Care and Residential Aged Care provider. Although the standards were legislated to come into effect on 1 July 2018 (with a transition period until 1 July 2019), the guidelines (I believe) are still in draft - the standards themselves only had a couple of minor changes through the consultation process.
Whenever new standards replace old, the first thing people ask is "what has changed?" Usually, standards-owners don't make the changes too dramatic - the words may move around, but to majorly change the intent or requirements of standards would place too much pressure on organisations, and government will generally try to avoid that.
With that in mind, I mapped the new Aged Care Quality Standards against the previous Home Care Standards, and Aged Care Accreditation Standards. And you can get a copy FOR FREE.
All you need to do is send me an email: firstname.lastname@example.org. You will need to include your work email signature*, and I'll send you a copy of the mapping. Please see below a sample from the first page:
This is a basic mapping tool, but should give you a head start on knowing what you might need to do for your quality management system (e.g. changing documents).
All the best for this new world of aged care.
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* by emailing me, you agree to have your work details - including your name, position, email, phone number, and organisation - stored on my records. I will never share or sell your details. You may be emailed from time to time with information on The Quality Nerd.
If you had a bit of a holiday break over Christmas and New Year, welcome back to work - you're probably full steam ahead, because human services never really stops, so here are some quick tips to get your year started right, quality management-wise.
1. Set your internal audit schedule - you might call this process or document reviews. However you do it, for your organisation, make sure you book it in now. Internally auditing or reviewing your organisation SHOULD NOT be ad hoc. Prioritise, based on risk, plan, and book in the relevant stakeholders.
2. Write or review your strategic or operational plans - or at least book in a review for later in the year. Now is a great time to revisit your business priorities. You can do this on a larger scale with your staff and clients, or it might just be a quick review to set some goals for the next few weeks.
3. Book in some time to get client feedback - again, this is about knowing where you are, and setting some goals for 2018. This process does not have to be formal (think paper or online surveys), although it can be. But if you're a small organisation, you might just call up your clients and ask them how last year went with regard to their services, and if they have any suggestions for this year. Record your findings in your Improvement Plan!
4. Schedule in staff training - training staff in human services should also not be ad hoc. You need to look at your client group and the type of services you provide, and tailor staff training accordingly. Schedule it in, book in external trainers if you need to, and evaluate the training afterwards. This is also a good time to chat to staff about their goals for this year, and review last year's performance and goal achievement. Or, book that chat in for later this year now.
I hope you have a great start to 2018. If you're a new organisation, you might be starting to think about your first external audit this year! I can help by checking number 1 from this list off for you, and conducting an audit on your business - see my Pricing page, or contact me.
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It's been a huge year for me at The Quality Nerd, as I followed my dreams and made the business my full-time job. I'm infinitely grateful for my clients that made the leap possible, and I'm very much looking forward to continuing to work with you in 2018.
For 2018, I hope for the following:
1. To support new businesses with their first external audits - if you registered as an NDIS or Home Care Provider in 2017, you will probably have your first audit in 2018. An audit can be scary if you haven't been through one before, but a great way to calm your nerves is to be prepared by having an internal audit. I have over 10 years experience in internal auditing, and I can help you with a desktop audit, or come to your site / office to thoroughly review your records.
2. Continue writing - I love to write, especially policies, procedures, tender applications, and self-assessments! I'm certainly not called a nerd for nothing. In 2018 I would like to support businesses by helping them write documents for their processes that are meaningful, useful, and compliant to requirements.
3. Travel with purpose - this links in with goal #2, in that I'd like to do more pro-bono work in 2018. That's right, if you're a small human services or animal welfare organisation, and you need some support with quality, processes, or management, I offer 1-2 days onsite of my time to help you with your business issues. All I ask is for permission to write a de-identified case study about you.
If you'd like to start 2018 with a business bang, please contact me any time: email@example.com
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Last week, the Review of National Aged Care Quality Regulatory Processes Report was released to the public. You can find it here: agedcare.health.gov.au/quality/review-of-national-aged-care-quality-regulatory-processes if you haven't already read it. This review was initiated due to the failures at a South Australian aged care and mental health facility, Oakden, that got a lot of media attention and public interest in how a facility that had been accredited by the Quality Agency could fail so badly and cause so much harm.
Let me say first and foremost - I, too, was absolutely appalled about the Oakden case. Things like that should never happen, and it makes me deeply sad and angry when they do. I will never not be an advocate for clients of human services, including residential aged care residents. My comment here is about our regulatory system and this review.
To make a blunt statement - I am very disappointed in the review report. I find it to be alarmist, unclear, and not objective. There are clear parallels with what has been recommended in the report to the direction that we in the sector know that both the government and the Quality Agency were steering us down anyway (e.g. the way in which facilities are audited, making the quality indicator program mandatory, and publishing the results online using a star rating system). None of this is new.
The review itself was triggered by the events and Oakden. Throughout the report, the authors write that the situation at Oakden (both in the type of service it provided, and its failures) were "not typical" but also "not unique". But they also state (much further down, I might add), that there was limited data to evidence it being not unique, and that what evidence they did have showed that overall, the sector is performing well. We are now faced with a dissonance between the evidence, and the need for making the recommended changes.
I have pages of the report highlighted - it would take me quite a few blog posts to go through each and every thought I had, and where I thought there were gaps. So this is my main comment:
The aged care sector has been going through reform, it seems, almost continually for the past 20 years. Instead of saying what we should do next, perhaps we could ask - why haven't previous reforms worked, and what can we do about ensuring that any further changes will work?
Briefly, I will say that I think we continue to look at the wrong things. It's not just about the quality standards, process, or accreditation. I do think we need to change the standards, because being based on a continuous improvement framework does not work in the sector. Changing them to being outcomes based isn't going to work either - we need to acknowledge that we need two frameworks. One being a safety and compliance framework, including clinical, where we say what facilities must have and must do. The other being outcomes focused, and supporting facilities to begin measuring outcomes.
But more than that - why does the government continue to shy away from addressing the issue of staffing, staff competency, and remuneration? We do not have staff with the skills needed to support the clients that are now in or entering aged care. We also appear to expect every staff member to be experts in dementia and behaviour management, but we are still paying them what we paid them when residents were low care and only needed help having a shower.
I once spent an hour and a half lying on the floor with a man with dementia while he was agitated. I was lucky to have the time to do that, but could staff on a normal day spend that time? Another gentleman with severe behavioural issues needed four staff on him for most of one day while I was visiting, which no facility can do every day. Our funding structure at the moment does not allow facilities to adequately staff for residents that need a high level of support. But these are not the things that the government directly addresses, even though they are mentioned over and over again by the sector - and were mentioned in this review report, although no meaningful recommendations were made.
If you'd like further comment from me on this review report, or on any aged care issue, please contact me at firstname.lastname@example.org
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It's been a dream of mine for a long time to help support small human services (or animal welfare!) organisations. It's part of the reason why I started The Quality Nerd and took the risk to go out on my own - I wanted to be able to provide pro bono support and advice to small NGOs, charities, or human services providers that might otherwise not be able to afford to hire a consultant.
I've decided there's no time like the present to start, so here are some dates that I'll be on the road. If you're a small organisation, get in touch with me. I can come and see you for two reasons:
1. To highlight your organisation and the great work that you! I have my blog and other social media platforms on which to promote you.
2. Because you've got a sticky quality question that you need answered.
Please email email@example.com, or head over to my contact page to book in with me!
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I just downloaded the latest resource from EVPA and Social Value International, released 12 September 2017. It's called Impact Management Principles, and it's a short, highline look at how non-government organisations (or what they call social purpose organisations) can incorporate impact management / measurement into their information collection processes.
Link to website
Link to resource
We're still getting used to the idea of measuring outcomes in human services organisations here in Australia, but the time when it becomes mandatory for many service types is fast-approaching. It can seem overwhelming - you need to plan, maintain, analyse, report. What I like about this resource is that it breaks down impact management into manageable parts, and they've presented the information in a very easy-to-read format - great for beginners!
Don't forget I have organisational review packages running until the end of November - book me now to start 2018 fresh and clear about where your organisation is at with regards to meeting quality standards. Email firstname.lastname@example.org
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Please let me know if there's any other quality or business topics you'd like me to cover in a vlog!
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The Quality Nerd loves all things Quality Management and Internal Audit...too much is never enough!