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?

• 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

High Risk Characteristics

2016/17 YTD 30 Jan-18

• No. of re-accreditation site audits

472 529

• No. of times new expected outcomes not met

15 18

• No. of review audits

33 37

• No. of times new expected outcomes not met

20 20

• No. of announced assessment contacts

583 233

• No. of times new expected outcomes not met

7 4

• No. of unannounced assessment contacts

2,876 1,740

• No. of times new expected outcomes not met

39 45 Summary of non-compliance in residential aged care services

Primary Intelligence Sources that Resulted in Findings of Failure and Serious Risk Decisions Nov 2015 – Jan 2018

Dept 26% ACCC 38% Public 6% Media 4% Unannounced 10% Reaccreditation 4% Risk Profiling 12% AACQA 26%

• 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

• ccur;

– 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

Serious Risk Decisions June 2016 to January 2018

Consumer Experience Reports

What would you say was the best thing about this home?

• Well run, it’s like a babbling brook
• Has lots of company if I need it.

Have met friends.

• Likes that has a say in what is

happening at the home

• They have improved my health.
• They will always offer you

something else if you don’t like what is being served.

• To be able to live as a couple but

still have individual rooms What is one thing you would suggest as an improvement at this home?

• Management and staff should

take notice of what is happening

• Food- sometimes very bad
• More freedom to go out.
• More sex
• Bit bored on weekends- could be

improved with more activities.

• To have more staff, especially

carers

Consumer Experience Report Open ended questions

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