Throughout 2022, the Aged Care Quality and Safety Commission (Commission) conducted a national roundtable discussion program with aged care providers called ‘Enriching Life Through Care’. The purpose of the program was to use the experience of providers to understand the needs of the sector, their interactions with the Commission and the challenges they face in delivering quality care.

The findings of the discussion program have been published in the Aged Care Quality and Safety Commission: Enriching life through care national roundtable program final report. In this article we summarise the key findings in the report.

Goals of the Discussion Program

The program focussed on three key areas:

• understanding and enabling a great aged care experience
• measuring performance in aged care
• engaging with continuous improvement.

 A key aim of the roundtable program was to give providers a chance to share their observations and experiences of engaging with the Commission. This, in turn, provided the Commission with information that it could use to improve its processes.

What are Providers and Consumers Saying?

The Commission held 22 roundtable events in each state and territory across Australia and heard from around 230 aged care providers on a range of issues related to these key areas.

Understanding and Enabling a Great Aged Care Experience

Providers had a lot to say about their role in the consumer’s experience of care and the challenges they faced. The Commission heard that quality and continuity of relationships with staff are highly valued by consumers, and that kind and respectful treatment was often more important than physical surroundings.

The roundtables also reaffirmed the importance of consumers being partners in their care and being treated as individuals. Consumers are asking to have their autonomy respected and to be empowered to participate in relationships and activities that give their lives meaning. One key challenge is that consumers and their families don’t always agree or share the same values and expectations about their care, and addressing this disconnect is an important part of honouring consumer needs and preferences.

Measuring Performance in Aged Care

Providers understood the importance of striking a balance between high quality clinical care and respect for a consumer’s autonomy and dignity of risk. One area that they identified for improvement was a need for more outcome-focused measurement and reporting that considers the entirety of the consumer experience and practical measures that support quality of life.

Providers expressed some frustration arising from the tension between reporting measures that speak to a medical model of aged care and the need to deliver wholistic outcomes and centre consumers in the care experience. They felt that including data on social, emotional and wellbeing measures within clinical governance frameworks would provide greater insight into the individual experiences of consumers. Providers of home services also noted the complex challenge of measuring an increasing number of consumer outcomes in situations where providers are only responsible for supporting some aspects of a consumer’s daily life.

Engaging with Continuous Improvement

Providers identified workforce culture as one of the critical aspects of continuous improvement. They identified several indicators of positive attitudes in the workplace, including:

• a “no blame” culture where mistakes and near-misses could be safely reported
• sharing and valuing lessons learned from mistakes or incidents
• a focus on customer service where consumers are empowered to speak up and are acknowledged and responded to
• staff who feel they can act on opportunities to improve the care and service experience.

What Has Been The Commission’s Response?

The Commission responded to the results of the roundtable discussions based on a few different themes:

Connecting with the Commission and Sharing Good Practice

The Commission heard that providers want more chances to engage with them outside of formal regulatory interaction and to share what is working well in addition to things that need improvement. Providers want more certainty around regulatory action and timeframes for certain matters. The Commission responded by sharing its intention to hold a national sector conference in mid-2023 to provide an update on regulatory reform and hear from providers, the Commission’s executive team and leaders in the sector.

Building Capability Through Communication and Education

Providers showed a desire for communication and educational materials to be written in plain English and tailored to role and service type. The importance of materials being readily available in multiple languages, or in other audio-visual formats, was also emphasised. The Commission noted that they are in the process of re-designing their website and expect a beta version to be available in the second half of 2023. They also affirmed their shift from static learning materials to more contemporary ways of learning.

Re-accreditation Audits for Residential Aged Care and Quality Audits for Home Services

Providers expressed frustration with some aspects of the re-accreditation and audit process for residential and home service providers. They feel that a focus on compliance means that they are less able to showcase what they are doing well in their service and that the audit process misses opportunities to share knowledge and education if issues are identified. The Commission referred providers to their Quality Assessor Code of Conduct and noted that it is working to improve its audit processes as part of the upcoming pilot program for the new Aged Care Quality Standards.

Reflecting Back How We Understand Sector Performance

Providers felt that the Commission had more of a role to play in the public conversation around aged care, including identifying and highlighting positive experiences within the sector and dispelling negative attitudes. In terms of sector performance, providers expressed a desire for the large volumes of data that are reported to the Commission to be presented back to the sector as a whole to help providers better understand their own performance and proactively manage risks. The Commission responded by presenting their recent report on SIRS incidents, which used a case practice approach to provide insights and guidance to help providers and their staff better understand the response, impact assessment and incident management aspects of SIRS reporting.

More Information

• Aged Care Quality and Safety Commission: Enriching life through care national roundtable program final report
• Aged Care Quality and Safety Commission: Quality Assessor Code of Conduct