Aged Care Essentials Article | Quality Assessments and Risk Management

With the upcoming Serious Incident Response Scheme and the ongoing threat of COVID-19, risk management in residential aged care is a hotter topic than ever before. It’s not a question of if the Aged Care Quality and Safety Commission (ACQSC) will assess your risk management system, but when.

In today’s article we explain what an effective Risk Management System looks like and how you can demonstrate that you have one for the purposes of an assessment.

Risk Management Requirements Under the Aged Care Quality Standards

Standard 8(3)(d) of the Aged Care Quality Standards requires aged care homes to demonstrate effective risk management systems and practices, including but not limited to the following:

• managing high-impact or high-prevalence risks associated with the care of consumers
• identifying and responding to abuse and neglect of consumers
• supporting consumers to live the best life they can.

The Board is Chiefly Responsible for Meeting this Requirement

Requirement 8(3)(d) is part of Standard 8 – Organisational Governance. The organisational statement for Standard 8 says “The organisation’s governing body is accountable for the delivery of safe and quality care and services.”

This means that your governing body (often referred to as “the Board”) has chief responsibility for meeting this requirement.

What is a “Risk Management System”?

A Risk Management System (also known as Enterprise Risk Management or ERM) is a structured process that helps your organisation predict future events that may impact your activities, and allows you to take appropriate actions to address the likelihood of the event happening, and/or the impact of the event should it occur.

Not all of these “future events” will have a negative impact. Some will present opportunities to support innovation and improve the quality of the care and services that is provided to consumers.

Notably, a Risk Management System a structured process. It is not ad hoc. It involves all staff recording relevant information in the same place in the same way; and it involves scheduled reviews by the Board.

For more information see our article: Top 5 Risks that Keep Residential Aged Care Managers Up at Night.

What are “Effective risk management systems and practices”?

An effective Risk Management System:

• identifies and assesses risks to the health, safety and well-being of consumers
• identifies and evaluates incidents and “near misses” (both clinical incidents and incidents in delivering care and services)
• provides information to improve an organisation’s performance and how it delivers quality care and services
• escalates risk/s to ensure timely management within and with out the organisation
• continues to monitor risks to consumers and others and takes action if a risk has increased.

As Standard 8 states, at a minimum the Risk Management System within the home must ensure management of high-impact or high-prevalence risks associated with the care of consumers; identify and respond to abuse and neglect of consumers; and support consumers to live the best life they can.

If you were to assess your current risk management system in line with these minimum requirements how would you rate? Does your risk management system clearly define and manage each of these areas and support your residents to “live the best life they can”?

How to Ensure you Risk Management System Passes an Assessment: Demonstrate a Narrative

When it comes to passing ACQSC assessments, it’s not enough merely to have an effective Risk Management System. You also have to demonstrate that your system is effective.

The first step in achieving this is to maintain thorough and accurate records. The next step is to present your records to an assessor in a way that tells a particular kind of story. In its barest form, this story goes like this: there was a risk, but our Risk Management System identified and responded to it and now the risk is managed and we are able to monitor it.

The vital element of this story is change. You want to show the assessors that your Risk Management System has changed things for the better. To do this you need records that show:

• what the risk was like before you addressed it with your Risk Management System
• how and when your system identified the risk
• how and when your system escalated the issue to management and the Board
• how you responded
• what the risk is like now and how you continue to monitor it.

Here is a very simple example:

• In the period April to July 2020 we had two separate “near misses” where two residents slipped a little on the same area of floor at different times.
• Staff investigated the area at the time but could not see any particular hazard. Nevertheless, they recorded the near misses in our Risk Management System.
• The near misses were noted in our regularly incident report that went to the Board in July 2020.
• The Board spotted the pattern and immediately organised for a more thorough investigation of the area. We discovered that, when watered, a nearby pot plant leaked, leaving water on the floor. Management organised for a catcher to be placed under the pot plant and this stopped the leak.
• There were no slips or near misses in the area for the period August to November 2020.
• We will be able to continue to monitor this through our reporting systems

Conclusion

• At some point, your residential aged care Board will have to demonstrate that they have an effective Risk Management System.
• A Risk Management System is a structured process that allows you to identify risks.
• To demonstrate the effectiveness of your Risk Management System you need to keep thorough and accurate records and then convey your data in the form of a narrative. This narrative should show how your system has changed things for the better.

Resources

Prior to Standard 8 in the Aged Care Quality Standards, there was no mention of Governance in the accreditation frameworks for Aged Care. And whilst the Royal Commission Aged Care commenced in October 2018, it wasn’t until mid-November 2019 that - for the first time - the focus of the Commission was Governance in aged care.

So, it’s no wonder that the Aged Care team at CompliSpace are finding that many Residential Aged Care Board members and Managers do not fully understand governance, risk and compliance and the true responsibilities of their roles. Afterall, it’s not uncommon for board members to be volunteers or to be from backgrounds that are not specific to aged care.

To help, CompliSpace will release two free resources in the coming weeks:

Resource 1: Webinar for Residential Aged Care Boards and Managers: An Essential Guide to Understanding Governance, Risk and Compliance.

Date: Tuesday, Dec 1

Time: 3:30-4:30 pm AEDT (Sydney time)

Cost: Free

Click here to learn more: https://attendee.gotowebinar.com/register/6073373889015177229

Resource 2: Training video: Enterprise Risk Management for Residential Aged Care.

This video will be released on Wednesday December 9^th. To pre-order this free training video, please click here and complete the form.