While the Aged Care Quality and Safety Commission (ACQSC) found 85% of aged care homes it audited in the second quarter of 2023-24 were compliant with all eight Standards, a surge in audits has identified a range of issues for residential care providers.
Clinical care remains one of the most complained about issues in residential aged care, according to the latest Sector Performance Report, as well as having high rates of non-compliance in aged care homes.
"Clinical issues are consistently in the most common complaints topics," the Aged Care Quality and Safety Commission (ACQSC)'s 66-page Sector Performance Report states.
"It is clear from the complaints data that higher quality clinical care remains very important to people receiving care and their families."
Though compliance with Quality Standard 3 (Personal care and clinical care) overall increased during the quarter, two Standard 3 requirements are in the top 10 requirements with the lowest compliance - delivering safe and effective personal and clinical care 3(3)(a) and managing high impact or high frequency risks 3(3)(b).
Standard 8 (Organisational governance) remains the Quality Standard with the lowest rate of compliance.
Other highlights of the 66-page report:
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The ACQSC's risk-based regulatory approach has resulted in 'early remediation' of a residential aged care home's non-compliance with the Aged Care Quality Standards in 50% of cases. Early remediation applies when the provider demonstrates to the ACQSC they are "willing and able" to fix issues quickly. "Where we see a problem, we raise it with the provider. They must show us that they will fix the issue quickly and then convince us that it is fixed. Where this happens, we do not give them a formal notice as these providers are doing the right thing by fixing their non-compliance without delay," the report states.
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Due to the increase in early remediation in residential aged care, the number of Directing Actions (a Direction to Revise a Plan for Continuous Improvement) and Compelling Actions (enforceable actions such as sanctions or non-compliance notices) are relatively low.
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The number of complaints the ACQSC received about residential aged care declined 15% in the December 2023 quarter compared with the same period in the previous year.
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There was a 40% increase in unexplained absences compared with the previous quarter, according to Serious Incident Response Scheme (SIRS) data. Priority 1 notifications are decreasing, while Priority 2 notifications are on the rise - the report suggests this could be because providers' understanding of the scheme has increased. (Priority 1 incidents must be reported to the ACQSC within 24 hours and include an injury or discomfort that needs medical or psychological treatment, inappropriate sexual conduct, unexpected death, unexplained absence, or reasonable grounds for reporting the incident to the police. Priority 2 incidents must be reported to the ACQSC within 30 days and include reportable incidents that do not meet the criteria for Priority 1.)
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In the December quarter, unreasonable use of force accounted for 56% of all notifications, according to SIRS data. Almost all of these incidents (around 90%) were incidents between residents.
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99 aged care workers have been banned from working in aged care since 1 December 2022, with 28 banned in the December 2023-24 quarter. Nine were banned for a set time, and 19 were banned permanently (14 of these orders involved people who have been banned in the past by the NDIS Commission).
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There was a surge in audit activity in the last two quarters of 2022-23 as the ACQSC caught up with a backlog of audits created by the pandemic. In Q1 and Q2 2023-24, the ACQSC returned to a "normal volume of audits and audit decisions compared with past quarters".
You can read the full report here.
