Accreditation is the evaluation process which aged care homes must undergo to continue receiving residential care subsidies from the Australian Government.
The main elements of the accreditation process are:
- self-assessment by the home against the Accreditation Standards
- submission of an application for re-accreditation (with or without the self-assessment)
- assessment by a team of registered aged care quality assessors at a site audit
- a decision about the home’s accreditation by a decision-maker (not part of the assessment team)
- issue of an accreditation certificate
- publication of the decision on this website
- unannounced visits to monitor homes’ on-going performance
The process of accreditation is outlined in the Quality Agency Principles 2013. Other legislation, notably the Quality Agency Act 2013, the Aged Care Act 1997 and various sets of Principles also apply.
Who is responsible for Accreditation? (Who assesses the quality of aged-care homes?)
A: An industry-funded body called the Australian Aged Care Quality Agency (AACQA) is responsible for the accreditation of aged-care facilities, in line with the current federal government policy of self-regulation by industry.
What are the Accreditation Standards?
A: Homes are assessed against four Accreditation Standards:
- Management Systems, Staffing and Organisational Development;
- Health and Personal Care;
- Resident Lifestyle and
- Physical Environment and Safe Systems
Each standard is divided into a number of Expected Outcomes. There are 44 Expected Outcomes across the four Accreditation Standards. Other information that may also be considered in the evaluation process including whether the home meets other responsibilities under the Aged Care Act 1997.
What are "Assessment contacts"?
An "assessment contact" is a visit to a home for one or more of the following purposes, however, occasionally, an assessment contact may be carried out by telephone:
- to assess the home’s performance against the Accreditation Standards
- to assist the home’s process of continuous improvement
- monitor the home’s progress against a timetable for improvement
- identify whether there is a need for a review audit
- provide additional information or training about the accreditation process and requirements.
The form and frequency of assessment contacts is decided on a case-by-case basis. We consider the particular circumstances of the home and the level and frequency of monitoring required. Homes with current or past failures to meet the Accreditation Standards may be visited more frequently than those with a record of consistently high performance. Assessment contact visits may be announced or unannounced. Each home receives at least one unannounced assessment contact every year.
Tell me more about "Self-assessment"?
Self-assessment is an internal process performed by the approved provider (not the agency), against each of the 44 expected outcomes and forms part of the application process for accreditation and reaccreditation.
The agency requires homes to conduct a self-assessment in preparation for re-accreditation and the approved provider must either submit self-assessment documentation with its application for re-accreditation, or make it available at the re-accreditation audit. Approved providers may use their own approach or use the agency's self-assessment tool.
What is a "Desk assessment"?
Desk assessment contacts are a telephone contact with a provider as part of the program of monitoring a home. A desk assessment contact may be conducted when the nature of information being followed-up does not require a visit. A desk assessment contact may also be conducted in some circumstances where a visit would be too restrictive due to travel, or other reasons.
A desk assessment contact is a planned teleconference with key personnel of a home. Desk assessments are rarely conducted and are generally used to monitor the progress of resolving issues identified at a home. A site visit is always conducted to determine if failure to meet Accreditation Standards are rectified.
What is a "Re-accreditation audit"?
A: A "Re-accredication audit" site audit is arranged when a provider applies for a further period of accreditation of a service. It is carried out prior to expiry of the service's existing period of accreditation and is a comprehensive assessment against all 44 expected outcomes of the Accreditation Standards. Each re-accreditation site audit is carried out at premises of the home by an assessment team made up of at least two registered quality assessors. Following a re-accreditation site audit, an audit report is prepared and is considered in deciding whether to re-accredit the service and the period of accreditation. Re-accreditation site audits are always announced.
If a home meets all the requirements of accreditation, they are normally accredited for a period of 3 years - but there are moves to extend accreditation to five years.
Prior to the audit, a home is obliged to inform residents and relatives about the upcoming re-accreidation audit - informing them when the audit will occur and that they have an opportunity to talk to members of the assessment team in private. The team must interview at least 10 per cent of residents or their representatives.
Following the audit, the assessment team prepares a report. The Agency then makes a decision about whether or not to accredit the home, and if so, for how long the home should be accredited.
What is a "Review Audit"?
A: A review audit is an onsite assessment of the quality of care and services provided to residents by a home, measured against the Accreditation Standards. Review audits are conducted by an assessment team of at least two assessors. Review audits may be announced or unannounced. The Agency may arrange a review audit if it considers that a service may not be complying with the Accreditation Standards or if there are important changes at the service that may warrant a review. The Agency must arrange a review audit if requested by the Secretary of the overseeing Department.
What is a "Type 4 Referral Review Audit?"
A: A review audit conducted at the request of the Department of Health and Ageing. It is the highest type of referral, to the agency.
What is an "Unannounced visit"?
An unannounced visit is an assessment contact or review audit that is carried out by an assessment team without prior notification to the approved provider. Unannounced assessment contacts are conducted as part of the agency's ongoing role in monitoring homes and their performance against the Accreditation Standards. Every home will receive at least one unannounced assessment contact each year.
The Agency are notified by the provider of key dates that may not be great days to have an unannounced visit and these will be taken into account. Facilities should do this to minimise the likelihood of disruption to scheduled events. If the Agency arrives to conduct an unannounced support contact and the facility has valid reasons why this is inconvenient and should not proceed then the most senior staff member on duty may consider refusing the Agency permission to enter.
What is a "Sanction"?
A: Sanctions are imposed by the Department on approved providers where there is an immediate and severe risk to the health, safety or well being of care recipients or where the service does not rectify continued non-compliance. Issues considered when making a decision to impose sanctions include whether the non-compliance is minor or serious, whether the non-compliance has occurred before and whether the health, welfare or interests of care recipients at the service are threatened.
When Sanctions are imposed on an approved provider, care recipients at the affected service receive a letter from the approved provider. This letter informs care recipients of the problems that caused the Sanctions and the actions the approved provider must take to fix the problems. The service is also expected to meet with care recipients and their representatives to tell them about the Sanctions and answer any questions. The Department closely monitors the service to ensure that problems are fixed quickly and that care recipients are supported during this period.
Information on all Sanctions imposed is published online. The information published includes the name and address of the services, the name of the approved provider, the Sanctions imposed under the Aged Care Act 1997, the reasons for imposing Sanctions, relevant dates and the status of the service.
According to the Department's website, information on Sanctions imposed is never deleted. Once a sanction expires, or is lifted by the Department, the published information is moved from “Current Sanctions” to “Archived Sanctions”. “Archived Sanctions” contains information on all Sanctions imposed by the Department.
Are fines imposed on a sanctioned nursing home?
No fines are imposed and government funding for existing residents is unaffected.
How long after a home has been accredited, does it take to be able to view a report?
A: According to the legislation, a home’s report should be "published" (made available to the public) between nine and 12 weeks after the site audit, where a reconsideration of the Agency’s decision is not sought.
How many requests have there been in writing for copies of previous accreditation reports since the policy regarding online storage of past reports was changed?
A: This information is not recorded.