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Accreditation Standards and Compliance in Residential Aged Care Homes (Nursing Homes and Hostels) in Australia

The Aged Care Act 1997 (the Act) specifies the care and services that must be provided to residents in aged care homes and the manner in which they must be provided.

Section 96.1 of the Act provides that the Minister may make “Principles” regarding a number of listed matters. Item 18 in the list refers to Quality of Care Principles, which came into effect on 9 January 2015.

Care and Services

Schedule 1 of the Quality of Care Principles sets out the care and services that must be provided for all care recipients who need them. There are 3 categories:

1. Hotel Services, including:

  • administration
  • maintenance of buildings and grounds
  • accommodation, including utilities such as electricity and water
  • furnishings
  • bedding
  • cleaning services
  • waste disposal
  • general laundry
  • toiletry goods
  • meals and refreshments of adequate variety, quality and quantity generally consisting of 3 meals per day plus morning tea, afternoon tea and supper, including special dietary requirements and fruit
  • social activities
  • emergency assistance, including at least one responsible person continuously on call and in reasonable proximity to render emergency assistance.

2. Care and Services, including:

  • daily living activities assistance, including personal assistance, individual attention, individual supervision and physical assistance with personal care, excluding hairdressing
  • meals and refreshments
  • emotional support
  • treatments and procedures, including supervision and assistance with taking medications
  • recreational therapy
  • rehabilitation support
  • assistance in obtaining health practitioner services
  • assistance in obtaining access to specialized therapy services
  • support with cognitive impairment, such as dementia and behavioural disorders, including individual therapy and specific programs.

3. Care and Services, (additional fees may apply, although there are a number of exceptions where no additional fees may be charged) including:

  • over-bed tables
  • additional bedding materials
  • mobility enhancing equipment
  • devices for lifting and moving the care recipient
  • additional goods for toileting and incontinence management
  • nursing services
  • a range of therapy services.

Accreditation Standards

Schedule 2 of the Quality of Care Principles sets out the way that the care and services must be provided. These are called the “Accreditation Standards” and for each matter they include both a principle and an expected outcome. There are 4 categories:

1. Management Systems, Staffing and Organisational Development, including:

  • the pursuit of continuous improvement
  • regulatory compliance
  • education and staff development
  • access to internal and external complaints mechanisms
  • planning and leadership including vision, values, philosophy, objectives and commitment to quality human resource management
  • inventory and equipment
  • information systems
  • management of externally sourced services.

2. Health and Personal Care, including:

  • the pursuit of continuous improvement
  • regulatory compliance
  • education and staff development
  • clinical care
  • identification and delivery of specialized nursing care needs
  • referral to appropriate health specialists
  • medication management
  • pain management to ensure care recipients are as free as possible from pain
  • palliative care
  • nutrition and hydration
  • skin care
  • continence management
  • behavioural management
  • mobility, dexterity and rehabilitation
  • oral and dental care
  • identification and management of sensory loss
  • achievement of natural sleep patterns.

3. Care Recipient Lifestyle, including:

  • the pursuit of continuous improvement
  • regulatory compliance
  • education and staff development
  • emotional support
  • independence
  • privacy and dignity
  • leisure interests and activities
  • cultural and spiritual life
  • choice and decision-making
  • security of tenure and understanding of rights and responsibilities.

4. Physical Environment and Safe Systems, including:

  • the pursuit of continuous improvement
  • regulatory compliance
  • education and staff development
  • providing a safe and comfortable living environment
  • providing a safe working environment
  • safe systems of work that minimise fire, security and emergency risks
  • infection control
  • catering, cleaning and laundry services to enhance quality of life.

In total, there are 44 expected outcomes that must be achieved and maintained.

Accreditation and Compliance

Aged care homes must be accredited to be eligible to receive government subsidies.

Accreditation, monitoring and compliance are the responsibility of the Australian Aged Care Quality Agency (the Quality Agency) This was previously the responsibility of the former Aged Care Standards and Accreditation Agency.

Aged care homes can be accredited for up to three years.

The Australian Aged Care Quality Agency publishes the most current publicly available report for each aged care home.

It is the responsibility of the approved provider to demonstrate that the aged care home meets the Accreditation Standards.

If the Quality Agency finds that any of the Accreditation Standards are not being met it may put the home on a timetable for improvement, which sets out the improvements and the maximum time allowed to address the expected outcomes that are not being met. The Quality Agency then monitors the aged care home’s progress in meeting the Accreditation Standards. If the issues are not resolved within the timetable for improvement, the Quality Agency may conduct a review audit and may vary or revoke the aged care home's accreditation. In addition, the Department of Social Services may decide to impose sanctions on the aged care home. If sanctions are imposed, a statement is placed on the front page of the reports referred to above.

More Information?

This Aged Care Guide comprises the following pages:

  1. Overview

  2. Eligibility and Assessment

  3. Fees and Charges

  4. Accreditation Standards and Compliance

  5. Resident Rights and Responsibilities

  6. Residential Respite Care

  7. Advocacy and Complaint Resolution

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