Sanctions on Baptistcare home a lesson for all

Sanctions on one of Canberra’s newest and grandest aged care facilities imposed by the Department of Health earlier this month is a timely reminder to all aged care providers to get their complaints and other systems in order.

Residents and family associated with the facility at BaptistCare Griffith were told on August 2 that the The Australian Aged Care Quality Agency had found the experienced aged care operator had failed to meet 21 of the 44 accreditation standards, prompting the Department of Health to impose sanctions.

The sanctions come just four months after the same agency met all 44 standards following a scheduled visit by the Quality Agency to what is widely considered one of Canberra’s best facilities.

Baptistcare Griffith, a purpose built aged care facility housing 160 residents, opened its doors in 2015 following the closure of Morling Lodge in Red Hill.

What the Quality Agency found in its unscheduled visit in July was serious enough to do an audit and a review of the standards, which revealed significant shortcomings in a number of areas including leadership, information systems, some human resources and clinical practices, effectiveness of staff education and continuous improvement processes.

The seven areas of concern highlighted by the Department of Health to be addressed are human resource management, clinical care, skin care, continence management, infection control, behaviour management and living environment.

Under the sanctions applied, Baptistcare won’t receive any new Government subsidies if it takes in new residents at Griffith in next six months. This will force it to focus on getting things right for the residents already there rather than new admissions.
Sanctions also require Baptistcare to appoint an administrator and an adviser for a period of six months and provide relevant staff training within six months, or its licence would be revoked.

It will be another week or so before Baptistcare and its residents learn the full outcome of the Quality Agency review (the facility is given a chance to respond to the audit review and then apply for reconsideration of its decision), but thankfully for it has wasted no time in implementing changes to a number of areas including the appointment of Aged Care Management Australia as an administrator and nurse adviser. It is their job to work with Baptistcare to bring it back to compliance and ultimately avoid the removal of its accreditation.

A sanctioned home usually has a varied period of accreditation once it gets back to compliance. This is to ensure the home continues to monitor improvements rather than fall back again – noting that the expected outcomes are minimum requirements not a gold standard. The period can be one year or two years depending on the degree of non-compliance.

At an at times heated meeting of Baptiscare Griffith residents last week, Baptistcare general manager of residential service Paull [Ed note Paull] English said the organisation was as shocked as were many residents at the position they found themselves in.

He blamed many of the unmet standards on BaptistCare Griffith leadership, information systems, some HR practices, some clinical practices, effectiveness of staff education and its continuous improvement processes.

The ‘weaknesses’ were a result of change of structure, management and leadership roles in recent months and the complaint process was fundamentally flawed, he said.

While several residents spoke of the exceptional care at the facility, some family members at the meeting were obviously aggrieved at the complaints handling process by the facility and the possible impact of care for their loved ones.

The issue of not enough staff to residents and the proper training of staff – one of the most prevalent complaints by residents and family across most facilities – were repeatedly raised.

English said the facility would focus on the skills of staff and their deployment rather than ratios – the principles of which didn’t fit with the way the aged care industry receives its funding.

He said that some of the measures outlined to improve things at the facility, some of which have already been implemented, included hiring a full time education coordinator to manage education and training of staff on site; contracting a clinical educator to monitor and train clinical staff; reviewing the staffing and skills mix; reviewing the roster including making additional resources available; clinical reviews with all residents and training.

The sanctions placed on Baptistcare were prompted by a referral from the Aged Care Complaints Commissioner, which followed a complaint from a resident, rather than issues identified in a scheduled visit. This highlights the importance of the July 1 move to make visits by the Quality Agency unannounced rather than scheduled.

It also highlights the need for a more robust and transparent complaints system and process to ensure that anyone considering a particular facility can have a greater level of confidence that important factors like staff levels and training and care needs are being addressed and delivered to the highest standards and not just the minimum.

Likewise, it indicates that when complaints are made, they are promptly responded to and used to improve quality and service.

It is three weeks since the Quality Agency found the facility to have serious failings and still there is nothing on its website to alert consumers of the review. The Department of Health put up its notice after the resident’s meeting on August 9, more than a week after it imposed the sanctions. The facility got letters out to residents and relatives within days of the sanctions but more than a week after it knew it was in trouble.

These and other transparency issues will hopefully be addressed with the establishment of the Aged Care Quality and Safety Commission. This body will undertake reforms including comparable compliance ratings for residential aged care homes and a new serious incident reporting system and is due to commence from January 2019.

The new independent Quality and Safety Commission came out of the Carnell-Paterson Review as a way to centralise accreditation, compliance and complaints handling. It will include the functions currently undertaken by Quality Agency and the Aged Care Complaints Commissioner.

Leading Age Services Australia (LASA) CEO Sean Rooney, said the aged care industry is judged every day against stringent professional and ethical standards and that it was looking forward to working with the government and other key stakeholders in the pursuit of quality system improvements in the service of older Australians.

For further information go to Baptistcaregriffith.org.au/Griffithupdate

• Bina Brown is a director of aged care services company Third Age Matters