New Quality Standards
The existing Quality Standards were introduced only a few years ago – in 2019 – to much fanfare. However, since then, the Royal Commission recommended (in 2021) a review of the Standards – ushering in another period of change and adjustment for the sector. The result is a set of strengthened Aged Care Quality Standards – the final draft of which was released on 15 December 2023. The Standards seek to improve outcomes – particularly in relation to choice, inclusion and quality of life – and aim to reflect a level of care that the community expects of aged care in this country.
Some notable themes to the Standards include:
The Person (Standard 1)
- Specific actions to ensure consumers’ identity, culture and life experiences are upheld and valued.
- Communication of financial information in a way that is clear, and easy to understand; enabling residents to exercise choice.
The Organisation (Standard 2)
- An emphasis on encouraging residents and their families to participate in identifying ways to reduce incidents from occurring. Timely action and open disclosure when problems arise.
Care and Services (Standard 3)
- Involving care recipients in the selection of care workers; and more general autonomy in receiving tailored care.
- Specific requirements introduced for caring for residents with dementia.
Clinical Care (Standard 5)
- Processes to ensure clinical care is trauma aware in responding to resident needs.
- New requirement for the provider and health professionals to agree on their respective roles, responsibilities and protocols for providing clinical care.
Food and Nutrition (Standard 6) –
- An entirely new standard to encourage providers to engage with older people about what and how they like to eat and drink, deliver choice and meals that are full of flavour, appetising and nutritious.
The Aged Care Quality and Safety Commission is currently preparing new guidance materials and assessment methodology to determine how the standards are implemented in practice.
From 1 July 2024, all government-funded approved providers are required to comply with the strengthened Standards. The existing Standards will remain in effect until then.
More information on the new standards can be found in the final draft, and on the Department’s Website.
A new, consolidated Act
A draft exposure Bill of the new Aged Care Act has been released for comment. The Act will repeal the Aged Care Act 1997 and place greater emphasis on older Australians, rather than providers. The Act will, amongst other things:
- Outline rights of residents with a fair, and culturally safe framework which places older Australians at the heart of the aged care system.
- Establish system oversight and accountability arrangements for governing bodies, which encourage delivery of high quality and safe aged care services.
- Impose a due diligence duty on responsible persons of a provider to take reasonable steps their conduct does not adversely affect the conduct of its residents. Responsible persons who commit a serious failure to meet this duty resulting in death, illness or serious injury of a person in their care may constitute a criminal offence liable for up to 5 years imprisonment.[1] Under the Act, a ‘responsible person’ includes any person responsible for the executive decisions of the registered provider, which may include a Board Member, director or executive.[2]
- Be structured to support the home care program commencing in 2025.
- Strengthen enforcement powers of the regulator by setting key governance responsibilities.
The new Aged Care Act will also replace the Aged Care Quality and Safety Commission Act 2018, which – despite having only been introduced in January 2019 – was the subject of heavy criticism in the 2021 Royal Commission. Key changes with the replacement of the existing Aged Care Quality and Safety Commission Act will include:
- Introduction of a comprehensive aged care worker screening database[3]. This will be accompanied with a nationally consistent pre-employment screening for aged care employees. Tightened employee regulation is accompanied by a new safeguard function of the Commission to better protect the delivery of safe and informed aged care services.
- New registration processes for aged care providers. All aged care providers will need to be registered, with each registration subject to a number of conditions. There will be a general requirement for providers to comply with conditions, and two levels of civil penalties where they fail to comply. Providers will need to re-register at the end of each registration period (3 years); and a failure to do so may attract penalties for both the provider and its responsible persons.
The new Aged Care Act is scheduled to commence on 1st of July 2024, and consultation on the draft bill closes on 16 February 2024
New Legislation
This is not the first time in recent memory that the regulatory landscape in aged care has changed. As mentioned, the existing Quality Standards, and the Aged Care Quality and Safety Commission Act, are each just a few years old; yet they are now being substantially revised or replaced. And the Aged Care Act itself has been amended countless times since its commencement – often with great hopes of a safe, high quality aged care system: In 2018, for example, the Commonwealth Government announced 23 aged care reforms in the Federal Budgets ‘More Choices for a Longer Life’.[4] The optimistic package aimed to prepare older Australians for a “healthy, independent, connected and safe life” and protect them from abuse.
Despite each past legislative attempt, the need for change across the aged care sector has not gone away. The findings and recommendations of the Royal Commission make this abundantly clear – in case there was any room for doubt following a succession of earlier reviews into aged care: Click here
It is not just providers now earmarked for change. Former finance secretary David Tune AO in the Final Report on the Independent Capability Review of the Aged Care Quality and Safety Commission labelled the Commission as a “near-dysfunctional regulator with areas missing one-third of their staff, overwhelmed by complaints, hamstrung by its legislation” in his 2023 report.[5]
Catalysts for change are not limited to the new Act and Quality Standards. The Office of the Inspector-General of Aged Care was established on 16 October 2023 in the wake of the Royal Commission, to provide independent oversight of the aged care system through its core functions of reviews, monitoring and reporting. And the Aged Care Taskforce – set up to review funding arrangements and develop options for a system that is ‘fair and equitable for all Australians’ is due to release its report (previously anticipated for December 2023 or January 2024).
Change cannot rely on legislation alone; and it remains to be seen how the sector – and even the Commission – respond to the changing regulatory landscape. Change also requires political fortitude, and time will tell whether the Aged Care Taskforce report is being delayed simply so that it falls after an upcoming by-election in one of the Victorian electorates – as has been reported.
Aged care providers can:
- prepare for the new Quality Standards right now, in time for 1 July 2024;
- follow the progress towards a new Aged Care Act, as updates become available; and
- keep up to date with the Government’s aged care reform roadmap – which they will update regularly to keep the sector informed: Click here
Stay tuned for further updates on aged care reform, from Panetta McGrath. With thanks to Tom Gillard, Law Graduate, for assistance with this article.
[1] Draft Bill s 121
[2] Draft Bill s 11
[3] Draft Bill s 166
[4] https://archive.budget.gov.au/2018-19/factsheets/more-choice-for-a-longer-life.pdf
[5] https://www.health.gov.au/resources/publications/final-report-independent-capability-review-of-the-aged-care-quality-and-safety-commission?language=en
