Industry Update, May 2023
Aged care funding reform committee
The next committee meeting is planned for this Friday
What’s New?
The Care Minutes and 24/7 RN guide has been re-issued with some changes. Note the definition of the PCA working under direct / indirect supervision has changes per my previous communications.
https://www.health.gov.au/resources/publications/care-minutes-and-247-registered-nurse-responsibility-guide?language=en
A revised Medication Guideline has also bee re-issued with some changes.
https://www.health.gov.au/resources/publications/guiding-principles-for-medication-management-in-residential-aged-care-facilities?language=en
Victoria has support from the Government to implement Allied Health Assistants into RACFs
https://www.health.vic.gov.au/allied-health-workforce/allied-health-assistant-workforce
AMO assessors
This dashboard provides an up-to-date performance measure on how the DoH and our industry are progressing with AN ACC
https://www.health.gov.au/resources/publications/an-acc-assessments-dashboard?language=en
Keep in mind some of the graphics are influenced by the size of facility or organisations.
We know there are significant delays in some cases to reassessments, bear in mind the AMOs have the same workforce issues with recruitment and retention as you do. If you have serious concerns email the team at
anaccoperations@health.gov.au
Dept of health
I recently put two queries to the Dept of Health regarding wording and clarification.
The first query was regarding the care minutes policy where providers are to accept and comply with the target minutes allocated from the previous QFR. My concern is where a provider expands into a new wing, or has significant change to class either due to occupancy or AN ACC uplifts, then the care minutes will impact either quality or financial outcomes if compliance is with the set minutes.
The answer from the Dept is as follows:
The average per resident per day care minutes targets are set quarterly (based on the residents from the previous quarter) to provide certainty about the care minutes responsibility (and hence staffing needs to meet it) in advance. This also avoid situations where the care minutes targets changed throughout the quarter as this would mean services may not know if they have met the responsibility until the quarter is over.
Our analysis suggests that the casemix of a service is generally quite stable over time, and so using the last quarter’s case mix to set the next quarters target is reasonable. However, I understand your concern about the two cases you presented. Its important to note that the care minutes responsibility will sit alongside existing provider responsibilities regarding appropriate staffing (e.g. Quality Standards 2, 3 & 7 and Part 4.1 Quality of Care, section 54-1(1)(b) of the Aged Care Act, which stipulates that approved providers are responsible for maintaining an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met). As such in the instance of a low care dependency service opening a new palliative care wing, the provider would be required to have adequate staffing to meet the high care needs of their new residents beyond what is required to meet their care minutes target (noting the target would adjust after one quarter). We will look into more clearly articulating this within the Care Minutes and 24/7 RN guide.
The opposite scenario of a high casemix service suddenly filling a new wing with low care dependency service is more challenging although likely very uncommon. In this instance the provider would be required to meet a higher care minutes target for these low care residents for one quarter before the target is recalculated to appropriately represent the new resident mix.
Essentially, I take from this response it is still your responsibility to adjust care minutes accordingly.
The second query was regarding medication management especially after the examples given in the new guides released. I wanted to really make sure PCAs could continue with supporting medication and the following response was given:
In relation to medication management and administration RNs, ENs and PCWs are able to work within their scope of practice which can under some circumstances include PCWs and ENs administering medicines under the guidance and supervision of an RN. Residential aged care services should refer to the Drugs, Poisons and Controlled Substances Act 1981 along with any specific rules for medication management and administration applicable to the state or territory in which they are operating.
Changes to networking group and newsletters
Our very successful networking group continues to grow in numbers, and with that comes a lot of organizing for speakers and updates in information. Due to the increasing need for support to a larger group I have unfortunately have been forced to apply a nominal fee to all networking meetings and this newsletter from 1 July 2023. We want to retain integrity to the information and retain our focus on communicating relevant information to enable your business decisions and performance.
Further information will be provided in the coming weeks. I appreciate to date everyone’s contributions to the success of our network and value your continued engagement to support each other.
Photo by Vlad Sargu on Unsplash
