Senate Community Affairs Legislation Committee, , 2:28:03 to 2:36:49
The Aged Care Quality and Safety Commission addresses the accuracy of the star rating system and provider compliance with safety standards.
Topics: Health, Integrity
Speakers: Hon Anne Ruston, Liz Hefren-Webb, Speaker 21, Speaker 22, Unknown Speaker
>> Thank you. Thank you. Um very much. Um just following on from some discussions we've had over the last couple of estimates about um the Northgate issue and and the star ratings. Um so as we know that following an inspection you identified that the Northgate facility was using unlawfully using restrict on residents but am I correct in saying you you did not issue a formal regulatory decision?
>> That's correct Senator. Yeah. So what
was the basis of choosing not to do that?
>> So um our approach is to uh work with the provider where they um acknowledge the issue and indicate that they're [clears throat] committed to working to address it. Our practice is not to issue a formal regulatory notice. um if we are uh confident that they are undertaking the steps that we've asked them to take. In this case, I think you'll recall we discussed that one of those steps was not taking any new entrance to the facility while we were working through the issues with them and getting the improvements in place. So,
are you now satisfied that you've worked through and you've got the improvements in place?
>> I I'm I'd say that we're um very pleased with the way they've responded to our concerns. They've shown a commitment to um improving the training and understanding of their staff >> around restrictive practices. um our team, our um restrictive practice unit has been closely working with them on ways to improve management of behavioral and psychological symptoms of dementia. >> Um but we would we are still closely monitoring the situation. I might see if Mr. Rae who's the head of our regulatory operations division wants to add anything.
>> Gary Rake, deputy commissioner, regulatory operations. um there are a range of very specific improvements that that service has put in place that uh respond to the concerns that we'd identified and we're we're quite happy with the way they are.
>> So in terms of the the two issues because I think you'd had an issue back in December of the previous year as well and then this this restraints issue um last year. So I suppose the question is and I think maybe you did just answer it Mr. break is that you are now satisfied that the concerns that were um raised on both of those non-compliance issues um are now resolved.
>> We're we're satisfied with the progress they've made. We continue to work with them to make sure that >> everything [clears throat] is as good as it can be. Some of the changes they've put in place, they've got a permanent quality safeguarding officer on the staff. >> They have uh a new clinical care coordinator and they are continuing to not accept new residents so that they
>> still not okay. No problem. Um and it was there I think there was also a requirement for them to appoint an advisor to help address these failures. Did that happen?
>> Yes. So they appointed an adviser and that transitions towards the new permanent staff that they have in those important quality roles.
was Northgate or did Northgate facility maintain a five-star rating through the entire process?
So, Senator, um I I checked just recently and I believe they have a four star,
>> it's four now, is it
>> rating and it's three stars for quality and but the overall rating is four
stars. >> So, it got dropped from five to four.
>> I don't know when it changed, but
>> it was five when we were here last time.
>> So, it must have been in between December and now.
>> So, I'm keen to understand the reasoning for that drop in the star rating. Was it as a rel is it as a result of the concerns that were raised in these two non-compliance issues? Was it an issue with staffing etc? Because I mean obviously there are fair few things that factor into it.
>> So as you know the department undertakes the star rating. So I might invite um Mr. Day to speak to that.
so currently the disability South Australian Northgate service has an overall star rating of four stars for their resident experience survey element of that they have three stars compliance five stars
>> so five stars for compliance and they've got two compliance activities out against them is that correct
>> so as um officials from the ageare quality and safety commission noted there was no formal regulatory action taken by the commission and they're the parameters for which the compliance ratings are impacted.
>> It [snorts] sort of seems a little weird to me. I mean obviously you're only using the system that you know you've got before you so there's no criticism of you in any way in what I'm about to say but so you got five stars on compliance so that's excellent. Um they've got quality measures at three stars which is acceptable. They've got resident experience at three stars which is acceptable and they've got staffing at five stars which is excellent. So overall rating four stars. So obviously either the quality measures or the resident's experience must have declined in that period because um previously it had been five stars but so it seems to me there's some fundamental flaws in the star rating system in terms of how the average punter who would go in and have a look at this would read that. Because if you can talk about excellence in compliance, it doesn't really go it's not reflected in the resident's experience. I mean, this facility has got a three-star resident experience. Is that not of a a concern to you?
>> So, the resident experience survey is an annual survey that um
>> Yes, I know what it is. I'm just asking you if there was a concern that we're talking about a five
senator. I think we last time spoke that the there are changes of push. >> Okay. Good to star ratings will reflect the work of the >> Um so I guess compliance is have they done what we have asked them to do? Have they responded to particular notices? um have they responded to our interventions?
>> Yeah, I suppose Miss Heer I'm sort of more concerned about I mean if I look at what the average person would think either as an older person and I and I'm sure this is how you would think too it's about the experience of the older person and the comfort that you give to the family of the older person that the experience of the older person um is is you know as as good as it possibly can be. So, we've got these measures of compliance. I mean, seriously, I don't think the average person cares less than that unless that compliance is actually flowing into a bad experience. In terms of staffing levels, I don't think anybody cares less about the staffing levels unless that translates into a bad experience for the for the older person. So, you got these two five-star ratings sitting here that are distorting the rating of the facility. And yet, the thing that probably matters more than anything else is the the consumer experience that's sitting at three stars. And so I mean I absolutely commend you in having a look at how these star ratings are working because it does strike me that we constantly have this conversation about the star rating system is really not very reflective of what I think Australians see as the value product of being in age you know that the experience of being in age care.
>> Yeah. So [clears throat] in going forward, the star rating around compliance will actually um reflect our most recent audit of the facility, >> but we're only now commencing our three-year program of audits under the new legislation. Over the next 3 years, we'll start to see, I think, a more nuanced kind of star rating outcome.
>> Yeah. Great.
>> Because the compliance rating will pick that up. At the moment it's being just drawn from whether we've formally issued compliance notices. So um I think we take your point and we're undertaking work collaboratively with the department