Commission remains focused on care minute non-compliance

Aged Care Quality and Safety Commissioner Janet Anderson PSM has welcomed the Aged Care Bill’s passage in her latest Commissioner’s message, while also warning providers about potential health risks over summer and the risk of ongoing care minute non-compliance.

Key points

• The Aged Care Quality and Safety Commission released its November 2024 bulletin, highlighting significant legislative and sectoral developments
• Focal points for the Commission include the Aged Care Bill’s passage through parliament and ongoing sector preparations for its implementation
• The Commission also shared insights into how it’s dealing with continued non-compliance, COVID-19 requirements in aged care and accommodation options for younger people 
• Expressions of interest for the second round of the Menu and Mealtime Review Program for residential aged care services closes on Wednesday, December 4

The passage of the new Aged Care Act is the focal point of the Commissioner’s monthly message. She said it paves the way for a new era in aged care in Australia that firmly places person-centred and rights-based care at the forefront.

“For the Commission, the new Act means a new regulatory framework which includes a clear, comprehensive set of obligations for providers and a more flexible and streamlined suite of powers for the Commission,” the Commissioner said.

“This will enable us to more effectively incentivise providers to improve their performance while also holding them to account through provider supervision, as supported by our Regulatory Strategy 2024–25.”

As the Commission already operates as a risk-based regulator, the strengthened regulatory model supports the Commission to continue to direct resources to the areas of highest risk and ensure the delivery of safe, high-quality aged care services. The Strategy is informed by:

• Evidence-based practice and the Commission’s recent Independent Capability Review
• Changes signalled by the new Aged Care Act
• Conversations we are having every day with older people, providers and workers

The Commission has also published a new section on its website, Changing aged care for the better, with information for older people, providers and carers. Ms Anderson said the section will be expanded as new information, resources and guidance become available.

Care minute non-compliance

The Commission shared an update on how it is dealing with non-compliance following the care minutes responsibility increase in October. 

October 1 saw care minute requirements increase to a sector-wide average of 215 care minutes per resident per day, including 44 minutes from registered nurses. An enrolled nurse can complete up to 10% of the nursing target. 

However, with just 40% of residential care providers meeting both care minute targets, some providers are consistently demonstrating non-compliance with their obligations. 

The Commissioner said many providers are actively working to meet their care minute targets, particularly as failing to do so results in rushed care and unmet needs. 

“We know from speaking to workers that this is also stressful for them. They feel that they’re not able to give the people they care for the time and attention they deserve,” Ms Anderson said. 

“However, there are providers with residential services that are still a long way from meeting their minimum care minutes targets. These providers aren’t able to show that issues with workforce availability or financial viability are major contributing factors to their continued non-compliance. These are the providers that need increased monitoring and supervision by the Commission.”

As per November’s Compliance Management Insights, providers have the opportunity to implement a suitable workforce strategy. They can then offer the Commission an enforceable undertaking which is closely monitored. The Commission issues a Non Compliance Notice if they do not accept an enforceable undertaking.

From there, providers can be sanctioned if they don’t meet commitments in an agreed timeframe. Civil penalties are imposed if a provider deliberately breaches their obligations under the Code of Conduct.

“Under our provider supervision model, we expect that if we take regulatory action against a provider, that provider will be able to meet their agreed commitments under the enforceable undertaking or other regulatory notice,” Compliance Management Group Executive Director Peter Edwards added. 

“This then avoids the need for us to impose a consequence. We’re more interested in the outcome than in increasing how often we use a regulatory tool.”

Protecting residents

Elsewhere, the Commissioner touched on several resident protection and care topics. She again reaffirmed the importance of mandatory care minutes in aged care, but also shed light on the danger of heatwaves, extreme weather events and COVID-19.

“As temperatures start to heat up around the country, now is the time to check your plans for heatwaves and other extreme events. Being prepared is vital to make sure that older people receive continuity of care and services,” she said. 

“Advice from the Bureau of Meteorology is that there is a high risk of heatwaves, bushfires, flooding and tropical cyclones during this summer. Planning and preparing for emergency events can reduce the impact on older people receiving care, and on staff. 

“Aged care providers must have effective plans ready and must also have ‘rehearsed’ them. This is especially important for providers of residential aged care services. Older people receiving home services and living alone may also be vulnerable.”

A warning over heat-related illness was also included. 

“Clinical signs of heat-related illness include confusion and clinical deterioration. This can quickly lead to serious illness and even death if not recognised early and responded to as a priority,” the Commissioner added. 

“Staff need to be able to recognise the clinical signs of heat-related illness, be aware of additional risk factors for each resident, and understand the environmental factors that may contribute.” 

Providers are encouraged to double-check state or territory and local government emergency management arrangements. Additional information is available on the Department of Health and Aged Care’s website. 

COVID-19 gained a mention weeks after the department emailed aged care providers directly. The Commission reinforced worries over low vaccination rates and urged providers to make sure residents are up to date. 

As of November 28, there were 1,377 active COVID-19 cases in residential aged care. Additionally, 21 new resident deaths and 1,313 combined new resident and staff cases were reported in the preceding seven days while 72% of aged care residents received a booster dose in the last 12 months. 

Click here to access the full suite of resources and information shared by the Quality and Safety Commission.