Australian Government - agedcare.royalcommission.gov.au · Aged Care Quality and Safety Commission...

CTH.4000.1001.0746

Australian Government

Aged Care Quality and Safety Commission

Final Quality Review Report

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Commission ID: -Introduction This is the final report of a quality review conducted at r·-·-·-·-·-·-·-·-·-·-·-·-·-·-·s"b"·-Pty-"Ltd"-·-·-·-·-·-·-·-·-·-·-·-·-·-·1

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C~.i?.J This report provides an assessment of the home service provider's performance, in relation to the home service, against the Home Care Standards, and any other matters the quality assessors considers relevant.

Services included in this quality review:

Home Care: · r·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-s-o-·-·F>ty·-·-cicf ·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-! t·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-!

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Assessment of performance I have found the home service provider of [~~~~~~~~~~~~~~~~!3-~~!¥.~f~~~~~~~~~~~~~~~~~~~]has failed to meet the following expected outcomes. I have not provided commentary on other outcomes that I am satisfied are met.

Standard 1 : Effective management

Principle:

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The service provider demonstrates effective management processes based on a continuous improvement approach to service management, planning and delivery.

Expected outcome 1.1 - Corporate governance

The expected outcome requires that "the service provider has implemented corporate governance processes that are accountable to stakeholders".

The home service does not meet this expected outcome.

Expected outcome 1.2 - Regulatory compliance

The expected outcome requires that "the service provider has systems in place to identify and ensure compliance with funded program guidelines, relevant legislation, regulatory requirements and professional standards".


Expected outcome 1.3 - Information management systems

The expected outcome requires that "the service provider has effective information management systems in place".


Expected outcome 1.5 - Continuous improvement

The expected outcome requires that "the service provider actively pursues and demonstrates continuous improvement in all aspects of service management and delivery".


Expected outcome 1.6 - Risk management

The expected outcome requires that "the service provider is actively working to identify and address potential risk, to ensure the safety of service users, staff and the organisation".


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Standard 2: Appropriate access and service delivery

Principle:

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Each service user (and prospective service user) has access to services and service users receive appropriate services that are planned, delivered and evaluated in partnership with themselves and/or their representative.

Expected outcome 2.1 - Service access

The expected outcome requires that "service user's access to services is based on consultation with the service user (and/or their representative) , equity, consideration of avai lable resources and program eligibility".


Expected outcome 2.2 - Assessment

The expected outcome requires that "each service user participates in an assessment appropriate to the complexity of their needs and with consideration of their cultural and linguistic diversity''.


Expected outcome 2.3 - Care plan development and delivery

The expected outcome requires that "each service user and/or their representative, participates in the development of a care/service plan that is based on assessed needs and is provided with the care and/or services described in their plan''.


Expected outcome 2.4 - Service user reassessment

The expected outcome requires that "each service user's needs are monitored and regularly reassessed taking into account any relevant program guidelines and in accordance with the complexity of the service user's needs. Each service users' care/service plans are reviewed in consultation with them".


Expected outcome 2.5 - Service user referral

The expected outcome requires that "the service provider refers service users (and/or their representatives) to other providers as appropriate".


Name of home service: i BO Pty Ltd i Date of quality review: 2'r·o·e.,Se'ii'ioer·20rn··················································································

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Standard 3: Service user rights and responsibilities

Principle:

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Each service user (and/or their representative) is provided with information to assist them to make service choices and has the right (and responsibility) to be consulted and respected. Service users (and/or their representative) have access to complaints and advocacy information and processes and their privacy and confidentiality and right to independence is respected.

Expected outcome 3.2 - Privacy and confidentiality

The expected outcome requires that "each service user's right to privacy, dignity and confidentiality is respected including in the collection, use and disclosure of personal information".


Expected outcome 3.5 - Independence

The expected outcome requires that "the independence of service users is supported, fostered and encouraged".


Areas in which improvements are required to comply with the Home Care Standards

The home service must make improvements to meet the expected outcomes listed above. A continuous improvement plan needs to be submitted by 12 February 2019.

The timetable for making the improvements ends on 31 January 2019.

If at the end of the timetable, the approved provider does not meet the Home Care Standards in relation to the service, the Commission will advise the Department of Health.

Assessment contact arrangements

In accordance with section 57 of the Rules, assessment contacts will be conducted in accordance with the arrangements outlined below, or at any other time (with or without notice).

Assessment contacts arrangements are as detailed below:

A desk announced assessment contact will be conducted in February 2019.

Notification to Department of Health In accordance with the Rules, a copy of this decision will be provided to the Secretary of the Department of Health.

Assistant Director Operations

Name of home service: r-············································ac:ffifY"Ltcf············································i Date of quality review: 2'1··o·e·ce-.noer·20ra-···················································································

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29 January 2019

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Introduction This report documents the performance of the service against each of the expected outcomes of the Home Care Standards as set out in the Quality of Care Principles 2014 based on the assessment conducted during the quality review.

Each service is required to undergo a quality review at least once every three years.

An assessment team appointed by the Quality Agency conducted the quality review on 21 December 2018.

The quality review was conducted in accordance with the Quality Agency Principles 2013 and the Accountability Principles 2014.

Team leader:

Team member/s:

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Audit trail

Company director

Finance Manager

Human resource manager

1

1

1

Care recipients and re resentatives

Care staff

Sampled documents Number Sampled documents

Home care packages care reci ient files

Other documents reviewed -

• Brochures given to care recipients

• Business plan

• Complaints register

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3

3

Number

• Email from Aged Care Complaints Commissioner - re no further action in relation to Mr ••s complaints

• Email to staff re contact details over holiday period

• Feedback forms from care recipients

• Incident forms

• Individual transition out plan for seven care recipients'

• Letter from lawyer re Mr-s termination of services

• Letter to care recipients re decision to no longer provider Home Care Packages

• My Aged Care portal

• Risk plan

• Staff documentation

• Transfer agreements with

• Transition out plan for service provider

• Training calendar and matrix

• Various correspondence with Department of Health

• Various policies and procedures

Observations

• Office environment

• Staff handling telephone enquiries

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The Statement of reasons below details the findings of the quality review and may reference information provided to demonstrate the service's performance against each expected outcome within the Standards. Performance against the expected outcomes within each Standard are rated as either:

• Met, or • Not met.

If you have received 'Not met' findings, the Statement of reasons will identify why the expected outcome was Not Met. Use this information to revise your Plan for Continuous Improvement to show how you will make improvements to meet all of the Standards.

Statement of reasons

Standard 1 : Effective management

Principle: The service provider demonstrates effective management processes based on a continuous improvement approach to service management, planning and delivery.

Expected outcome 1.1 - Corporate governance I Not met

The expected outcome requires that "the service provider has implemented corporate governance processes that are accountable to stakeholders".

r·························································s[f PtyTtcr·················-·····································1 is a small privately owned

·~fria· r-·un l)us-in-ess-·wfiTCFl.llas-bee·n-6peratfr1g-for-~ip-proxlmateiy two years providing nursing services on a brokerage basis to other service providers. The business received Approved Provider status in February 2018; the first of their packages began in May 2018. The Director is a registered nurse (RN) and the management team consists of a finance manager and a human resources manager each with delegations and responsibilities outlined in their contracts. The My Aged Care portal shows the company has been providing services to 17 Home care packages (HCP) care recipients in metropolitan

ranging from levels 1-4.

Management stated that in September 2018 they were approached by another HCP .P.r_qy.~9~!!.ti.<?.~e Care Assist, who was relinquishing their HCP and requested f"~i)·;~~-~~~-l 1 .... ~.l?.-~!Y.1:-!~ __ Jtake over their 17 care recipients from 1 October 2018. Howeve-r··--·----" management advised that due to the requirements needed to meet their approved provider responsibilities they have chosen to no longer continue as a HCP provider and are in the process of transferring all their care recipients to other providers.

Reasons for findings for home care service:

Management have not implemented corporate governance processes that are accountable to aged care stakeholders. Management did not understand their governance responsibilities in relation to the home care common standard and did not have processes to identify and monitor their requirements as an approved provider. The service's performance against other expected outcomes demonstrates there is not an effective corporate governance system in place.

Supporting Information

Management have not implemented corporate governance processes that are accountable to aged care stakeholders.

• Management advised that when entering into the home care package arena they did not fully research or understand their corporate qovernance requirements or

Name of home service: r · --·-·-------·-·-------·-·· si:f Pty Ltd--·-·-------·-·-------·-·-· 1 Date of quality review: 21--o·e·ce'riioef20'f8'"··············································································"

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Expected outcome 1.1 - Corporate governance I Not met

responsibilities. Therefore they did not develop corporate governance processes that meet the requirements of the Aged Care Act 1997 (the Act).

• Management advised that as they have decided to no longer provide HCP services they are no longer actively implementing corporate governance processes relevant to the requirements of an approved provider under the Act.

Management did not understand their governance responsibilities in relation to the home care common standard and did not have processes to identify and monitor their requirements as an approved provider.

• Management advised they did not have a system to identify or monitor compliance with their corporate governance requirements as an approved provider; however, they have now assigned portfolios to each of the management team to monitor and report to the management team on compliance issues and changes.

The service performance against other expected outcomes demonstrates there is not an effective corporate governance system in place.

• The service does not meet six of the eight Expected outcomes in Standard 1 Effective management:

o The Director advised they were unable to demonstrate any monitoring processes they undertake to ensure governance process are accountable to stakeholders.

o Management advised they do not have system to identify or monitor compliance with their regulatory compliance requirements with funded program guidelines, relevant legislation, regulatory requirements and professional standards.

o The Director advised they were unable to demonstrate any monitoring processes they undertake to ensure information management systems are effective.

o Management advised that when entering into the home care package arena they did not fully research or understand the community in which it would be operating and therefore did not reflect this in service planning and development.

o Management advised they could not demonstrate they are actively pursuing continuous improvement in all aspects of service management and delivery.

o Management could not demonstrate they are actively working to identify and address potential risk, to ensure the safety of service users, staff and the organisation.

Additional Information

Information provided at the site visit shows since the assessment contact visit on 31 October 2018 management have developed a plan for the transfer of care recipients to other providers. All care recipients have been provided with written information advising of the management decision to no longer provide HCP. Other information provided to care recipients included a list of other local HCP service providers, the Charter of rights and responsibilities, advocacy services and complaints commission details; the Director has meet with each care recipient to discuss their options. Once a new provider has been chosen an individual transition plan is developed in consultation with the care recipient and the new provider. To ensure a smooth transition and continuity of care i-·-·-·-·13-D-Pty-·LtcT-·-·-1 L~:~:~~~~;~jstaff are being brokered by one of the new providers as an interlm .. -~:irri:ingemenf· Management advised staff have been offered employment by one of the new providers if they wish to continue with the same care recipients. Two of three staff interviewed said they have been offered the opportunity of transferring employment to the new provider. Care recipients interviewed said management have meet with them and they have been provided information on what is happening and assistance in understanding their options.

Name of home service: r=:=:=:=:=:=:~:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:~!.~="!~:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=:=1 Date of quality review: 21 December 2018

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Expected outcome 1.1 - Corporate governance Not met

As at 21 December 2018 care recipients status is as following:

• Already transferred: • Level 2 - Transferred to -Home Care

17 December 2018. • - Level 3 -Transferred to -Home Care 18

• - Level 3 -Transferred to -Home Care 18 December 2018.

• Level 3 - Transferred to -Home Care 13 December 2018.

• - Transferred to - residential care 27 November 2018 .

• • Transferred to residential care 30 November

2 18. • - Management advised they terminated Mr s services due to his

aggressive behaviour toward staff. Mr is not receiving services and a letter of termination was sent to Mr by the provider on 23 October 2018.

Transfers in process:

•

•

•

•

•

•

•

- Level 3 - Official transfer date for transfer to -Home Care 24 December 2018. ••••••••••••I- Level 3 - Official transfer date for transfer to ..

Home Care 31 December 2018. Level 2 --staff have met with the

and offered a place. Level 2 --staff have met with the care

recipient discussed services and offered a place. - Level 3 - Offered transfer to -Home Care -

discussing with her lawyer before she accepts offer. - Level 2 - Official transfer date for transfer to

Nursing Service 7 January 2019. - Level 2 - transferring to in New

Transfers yet to arranged:

• • - Level 3

• • - the care recipient is currently in hospital and is not

expected to return to community living, ongoing discussions with the care recipient's representative are occurring.

Expected outcome 1.2 - Regulatory compliance I Not met

The expected outcome requires that "the service provider has systems in place to identify and ensure compliance with funded program guidelines, relevant legislation, regulatory requirements and professional standards".


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Expected outcome 1.2 - Regulatory compliance Not met (-·-·-·-·-·-·-·EiD._Pty.itci-·-·-·-·-·-·-!was unable to demonstrate that the service has systems in place Lrcs·-rae"i"illfY"an<fens-Ci.re-compliance with aged care funded program guidelines, relevant legislation or regulatory requirements. Care recipients were not provided relevant information including a care plan outlining their agreed care and services or a budget statement to assist them to develop their service agreements with [~~~~~~~~~~~~~j3-~~~~fy~~~i~~~~~~~~~~~~~~J prior to commencing services. Management advised care recipients have not signed the amended service agreements to reflect the updated information and therefore they still do not have service agreements in place. Mr-s services were terminated without proper consultation or referral. The service does not have a process monitor compliance with their requirements as an approved provider or employer. Care recipients said they have recently been provided with written information about their services and with budget statements but did not know about the current quality review.

Supporting information

Care recipients were not provided relevant information including a care plan outlining their agreed care and services or a budget statement to assist them to develop their service agreements with :·-·-·-·-·-·-·-·-·-sD"PtY-·LtiT·-·-·-·-·-·-·-·-iprior to commencing services. Management advised care recipients have not signed the amended service agreements to reflect the updated information and therefore they still do not have service agreements in place.

• __ M§0_~.9~IT!E?.D.t.?_tjylsed that while care recipients commenced services with [8-~-~~tJ.~1.!~J l·-·-·----~l?._.~_ty__!:-_t~·-·-·-·-j between 1 October 2018 and 15 October 2018 they were not provided with care plans or budget statements until November 2018. Home care agreements have not been signed by the provider or the care recipients to reflect this updated information. Management said they felt it would be too confusing to ask care recipients to sign the[~~~~~~~~~~~~~~~~)~i?.~¥.!Y~~~t-~~~~~~~~~~~~~~~~Jservice agreement because they are now entering into new service agreements with new providers.

• Care recipients were not provided with the Charter of rights and responsibilities -Home care on commencing with r-·-·-·-·-·-·-B-ff.Piy-itcf-·-·-·-·-·-·i. The Director said this information was provided to them--rece"fmy·.-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-··

• Management stated they have not asked care recipients to sign a 'consent to release information' form; however, they have obtained verbal consent to discuss care recipient's personal circumstances with other providers. Care recipients interviewed said they had been asked for consent to discuss their personal information with other providers.

A care recipient's services were terminated without proper consultation or referral.

• The director advised they are aware they did not follow the correct procedure to terminate Mr -'s services and have since tried to rectify the situation. A formal letter of termination was sent to Mr by the provider on 23 October 2018 and his details have been referred back to My Aged Care. o The RN interviewed advised Mr~as only receiving wound care services

and stated Mr-s wounds were healed prior to services being discontinued. o Management advised they are not aware if Mr is receiving services

elsewhere. o Documentation provided at the site visit shows both the Aged Care Complaints

Commissioner and the Police have investigated claims made by Mr 's about his termination and are taking no further action.

The service did not have a process to identify or monitor compliance with their requirements as an approved provider.

• Management advised they did not have system to identify or monitor compliance with their requirements as an approved provider; however they have now assigned portfolios to each of the management team to monitor and report to the management

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Expected outcome 1.2 - Regulatory compliance I Not met

team on compliance issues and changes.

Care recipients said they have recently been provided with written information about their services and with budget statements but did not know about the current quality review.

CTH.4000.1001.0757

• The Director said the service decided not to inform care recipients about the current quality review because they were already receiving so much other information in relation to their new services.


• Care recipient interviewed sa id they are now receiving monthly account statements.

Expected outcome 1.3 - Information management systems I Not met

The expected outcome requires that "the service provider has effective information management systems in place".

Reasons for findings for home care service: ~-·-·····-···-···-···-···-···-···-···-···-···-···-·····-!

i BD Pty Ltd !could not demonstrate an effective information management '-·-···-·-···-·-·-···-·-·-·-···-·-···-·-·-·-···-·-···-·-' system to support all aspects of services. The service does not have systems to ensure relevant information has been provided to care recipients. The service does not have system to ensure currency of information provided or that care recipients understand and agree with the information that is provided. Feedback processes for both staff and care recipients have been developed; however, they have not been implemented. The service performance against other expected outcomes demonstrates there is not an effective information system in place.


The service does not have systems to ensure relevant information has been provided to care recipients.

• Management advised they do not have a check list or monitoring procedure to ensure all relevant and required information has been provided to care recipients.

The service does not have system to ensure currency of information or that care recipients understand and agree with the information that is provided.

• Home care agreements have not been signed by the provider or their representative .

• Management said they felt it would be too confusing to ask care recipients to sign the r-------80Jity-Lt'd-----·--i service agreement because they are now entering into new "servfce-agreemenfS-wiln new providers.

• None of the nine care plans viewed were dated .

Feedback processes for both staff and care recipients have been developed; however, they have not been implemented.

• The service does not hold staff meetings for support staff which would enable them to provide feedback or make suggestions for improvements.

• All staff interviewed stated they only have access to information via the mobile phone 'App' or text. There are no staff meetings or other means of keeping them up to date with care recipient's needs or other relevant information

• All staff interviewed said they have not been provided with written information other than the terms of their employment. Information on which care recipients they will be assisting and when is provided via the phone App or via texts.

The service performance against other expected outcomes demonstrates there is not an effective information system in place.

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Expected outcome 1.3 - Information management systems I Not met

• The Director advised they were unable to demonstrate any monitoring processes they undertake to ensure information management systems are effective.

Expected outcome 1.4 - Community understanding and Not met engagement

The expected outcome requires that "the service provider understands and engages with the community in which it operates and reflects this in service planning and development".


Management were not able to demonstrate they understand and engage with the community in which they operate and therefore did not reflect this in service planning and development. Management advised that due to the requirements needed to meet their approved provider responsibilities they have chosen to no longer continue as a HCP provider.


Management were not able to demonstrate they understand and engage with the community in which they operate and therefore did not reflect this in service planning and development.

• Management advised that when entering into the home care package arena they did not fully research or understand the community in which it would be operating and therefore did not reflect this in service planning and development.

Management advised that due to the reguirements needed to meet their approved provider responsibilities they have chosen to no longer continue as a HCP provider.

• Management advised that due to the requirements needed to meet their approved provider responsibilities they have chosen to no longer continue as a HCP provider.

• The service is currently in the process of transferring all their care recipients to other providers.

Expected outcome 1.5 - Continuous improvement I Not met

The expected outcome requires that "the service provider actively pursues and demonstrates continuous improvement in all aspects of service management and del ivery''.


[~~~~~)~~i?~~~II~.~~~~~~] is not actively pursuing and could not demonstrate continuous improvement in all aspects of service management and delivery. Since the assessment contact visit on 31 October 2018 feedback processes for both staff and care recipients have been developed; however, they have not been implemented. Staff and care recipients interviewed are not aware of continuous improvement processes.


L~~~~~~~~~~~~~~~~~~e~P.:~It~C~~~~~~~~~~~~J is not actively pursuing and could not demonstrate continuous improvement in all aspects of service management and delivery.

• The management team stated they have developed a continuous improvement plan; however, their focus now is on transferring care recipients to other providers as they have decided to relinquish their approved provider status.

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Expected outcome 1.6 - Risk management Not met

The expected outcome requires that "the service provider is actively working to identify and address potential risk, to ensure the safety of service users, staff and the organisation".


i~:~:~:~:~:~:~:~:~$~}~ixii~C:~:~:~:~:~:Jhas developed a risk management framework but the service has not always understood their obligations in relation to ensuring the safety of service users, staff and the organisation. The service does not have effective monitoring processes for this expected outcome. Care recipients risks had not been identified until assessment were conducted in November 2018 approximately two months after their services commenced; and this information is not always made available to staff to ensure safe delivery of care and services according to their rights, needs and preferences.


L~:~:~:~:~:~:~:~$.J5-:~~:frI!~~:~:~:~:~:~:~:~Jhas developed a risk management framework but the service has not always understood their obligations in relation to ensuring the safety of service users, staff and the organisation.

• The management team advised they were not aware of the Home Care Standards until being contacted by the Australian Aged Care Quality Agency (AACQA) in October 2018 and are therefore still developing processes.

The service does not have effective monitoring processes for this expected outcome.

• The management team stated they have developed a risk management plan; however, their focus now is on transferring care recipients to other providers as they have decided to relinquish their approved provider status.

Care recipients risks had not been identified until assessment were conducted in November 2018 approximately two months after their services commenced; and this information is not always made available to staff to ensure safe delivery of care and services according to their rights, needs and preferences.

• Assessments for 22 November 2018 and 21 November 2018 indicate they are prone to falls but this information was not transferred into care plans to alert staff.

• Only two of ten care recipient files viewed contained a completed Home Safety assessment. The Director said the remaining eight Home safety assessments had not been completed. The following care recipients did not have a Home safety assessment:

0

0

0

0

0

0

0

0

• None of the ten care recipients' files viewed contained care recipients' individual instructions to guide staff in the event they fail to respond to scheduled visits. Management advised there is an informal policy and staff are to ring the office if this occurs; staff interviewed were aware of this procedure.

Care recipients were satisfied services were delivered safely.

• All care recipients and representatives interviewed said services were safely delivered but said they did not recall being asked about their preferred instructions in the event

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Expected outcome 1.6 - Risk management I Not met

they failed to respond to a scheduled visit. One care recipient said staff always provide stand-by assistance with their mobility and personal care.

Expected outcome 1.7 - Human resource management I Met

The expected outcome requires that "the service provider manages human resources to ensure that adequate numbers of appropriately ski lled and trained staff/volunteers are available for the safe delivery of care and services to service users".


The service provider manages human resources to ensure adequate numbers of appropriately skilled and trained staff are available for the safe delivery of care and services to care recipients. Documentation reviewed shows recruitment, induction; job description and training ensure staff have appropriate skills and guidance to undertake their roles. Monitoring processes include training registers, police clearance, statutory declarations, and qualification registers. There is a training matrix and training calendar for 2019. Training provided included manual handling, infection control and first aid. Staff interviewed said they are provided with enough time to complete the care recipient's individual services. Care recipients interviewed stated staff are professional , helpful and respectful.


• All staff interviewed were aware of the decision by management to no longer provide HCP services and said they have been consulted about their options. Two staff interviewed said they have been offered the opportunity of transferring employment to the new provider.

Expected outcome 1.8 - Physical resources I Met

The expected outcome requires that "the service provider manages physical resources to ensure the safe delivery of care and services to service users and organisation personnel".


The service provider has new systems to manage physical resources and ensure safe delivery of services to care recipients and staff. The service's new office is leased and the contract includes repairs and maintenance. The new office space has care recipient access and areas for private conversations. The new premises have a range of storage and meeting areas. There is a register to ensure staff who transport care recipients in their own vehicles have appropriately registered and insured vehicles. Staff are provided with a range of goods and equipment, including personal protective equipment (PPE). Management advised equipment for care recipients would be purchased or hired from their package funds after a suitable assessment has occurred; at this stage only wound dressings have been provided. Staff interviewed said they are provided with equipment and training in how to use it. Results show the service provider has a range of procedures to ensure services are delivered in a safe manner.

Additional information

• The service relocated its office from private premises to a commercial address on 12 November 2018. The new office space allows for care recipient access and areas for private conversations. Management and staff now have access to a private office, and storage and training spaces.

Name of home service: L.~.~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~.~~~.!fy~~f.Ci~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~·~J Date of quality review: 21 December 2018

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Expected outcome 2.1 - Service access I Not met

The expected outcome requires that "service user's access to services is based on consultation with the service user (and/or their representative), equity, consideration of available resources and program eligibility".


CTH.4000.1001.0761

[~~~~~~~~~Q.~~jyJ_t_~~~~~~~Jcould not demonstrate that it has effective systems to ensure each care recipient's access to services is based on consultation with the care recipient/representative, equity, consideration of available resources and program eligibility. Care recipients were not provided appropriate or timely information such as their rights and responsibilities in relation to consumer directed care, individual care plans detailing agreed services or budget statements reflecting service costs until approximately two months after they had commenced services. The self-assessment did not address the requirements on how the service monitors compliance with this expected outcome. Both care recipients and the representative interviewed said they were satisfied with their transfer out arrangements.


Care recipients were not provided appropriate or timely information such as their rights and responsibilities in relation to consumer directed care, individual care plans detailing agreed services or budget statements reflecting service costs until approximately two months after they had commenced services.

• The Director said they visited all care recipients who commenced with i-·-·-·-sjj"-j>"iy-l."tCi-·-·-·j i-00-·Fity·-cici-·ibetween 1 October 2018 and 15 October 2018 to discuss thelr.care-·n-eeds·-·-·-'-·-·-·-·-·-·-·-·-·-·-' and service requirements. At this stage the care recipients signed a service agreement however those agreements did not include care plans detailing agreed services or budget statements outlining the service costs. Care plans and budget statements were not developed or provided to care recipients until after mid-November 2018.

• The Director said that by mid-November 2018 the care recipients had commenced transferring to other services and were entering into service agreements with their new approved providers. !~~~~~~~~~~-ii~~~:.1_i~:.~~~~~~~)herefore made a decision not to request the amended service agreements be signed by the care recipients in order to minimise the potential for confusion. The Accounting and Finance manager confirmed seven care recipients have been assisted to transfer out of :-·-·-·-·-·-·-·-·so-·PtyiiCi·-·-·-·-·-·-·-·1 !-~~·~;~·~;~-! r·-·-·-·Efr»-Piyiici-·-·-·-! has 11 care recipients on their bo~-i<·5·-w:rn1-·1·a·-care-·reclpleil"ts'·-·-·-·-·-·-·-·· 'cLfrrE":frifl~/"re-celvfri·g services. One of the 11 care recipients is in hospital and is not expected to return to community living. Refer to Expected outcome 1.1 Corporate governance.

The service does not have effective monitoring processes for this expected outcome. The self-assessment did not address the requirements regarding how the service monitors compliance with this expected outcome.

• The service's self-assessment did not identify care recipients' initial service agreements did not include care plans or budget statements as required by Consumer directed care and outlined within the Charter of Rights and Responsibilities -Home Care. The Director stated they had not fully understood Home care package

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Expected outcome 2.1 - Service access I Not met

requirements at the time these care recipients were admitted into the service.

• The Director said !~~~~~~~~~~-Ci~tY.:.~f(~~~~~~~J has not developed a monitoring process for this expected outcome as they no longer intend to be an approved provider.

Both care recipients and the representative interviewed said they were satisfied with their transfer out arrangements.

• Both care recipients and the representative interviewed said they had discussed their care needs and service requirements on admission with the Director. They confirmed they have been receiving the services as discussed. They said they have since received a care plan and budget statement.

Expected outcome 2.2 - Assessment Not met

The expected outcome requires that "each service user participates in an assessment appropriate to the complexity of their needs and with consideration of their cultural and linguistic diversity".


r·-·-·-·-·-·-·-·95·-Pty-"Licf-·-·-·-·-·-·-·1was unable to demonstrate that the service undertakes '-assess-m-E:infpro-cesses-·which identify care recipients' care and service needs within a sufficient time frame to enable the development and provision of care plans to care recipients within 14 days of commencement of services. Staff interviewed said they did not receive documented information about clients until recently. The service does not have effective monitoring processes for this expected outcome. Care recipients interviewed said they remember having a[~~~~~~~~~~~~~~~~~~~~~~!Y~~!~~~~~~~~~~~~~~~~J representative visit their home to when commencing with the service but none could remember having a formal assessment completed until recently.


[~~~~~~~~~-1?~~!.¥.If.f~~~~~~Jwas unable to demonstrate that the service undertakes assessment processes which identify care recipients' care and service needs within a sufficient time frame to enable the development and provision of care plans to care recipients within 14 days of commencement of services

• Files viewed for care recipients currently receiving services showed all 10 had undergone an assessment in the last month. Assessment information collected included current and past medical diagnosis, medications, cognitive, sensory and functional abilities, continence, mobility, nutrition, allied health requirements, falls and individual risks, equipment, strengths, interests and actions required. A progress note entry provides information about the care recipient's background, family and lifestyle.

• Two of 10 care recipients' files contained My Aged Care reports and ACAT assessments which correlated with assessments and care plans. The Director said ACAT assessments were not printed but accessed on the My Aged Care portal as

required. -·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-• All 10 care recipients listed below had commenced with l_·-·-·-·-·-·-·-·-1?.-°-·-~~.Y.-.~~-~---·-·-·-·-·-·-·-.i

between 1 October 2018 and 15 October 2018 however no assessments had been undertaken before 15 November 2018:

o HCP Level 3 assessment completed 22 November 2018; date , diagnosis includes shortness

, falls in home with recent discharge from rehab following hospital admission September 2018. -••• assessment states assistance is required for activities of daily living, shopping and guidance with cooking for two hours, five days a week.

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Expected outcome 2.2 - Assessment Not met

o HCP Level 2 assessment completed 19 November 2018 (in hospital); and 17 December 2018 (at home). Date of birth•••• osteoarthritis discharged from hospital •December 2018 following fractured ankle. 's assessment states assistance is required with showering five ti e eek

o HCP Level 3 assessment completed 23 November 2018; date of birth ----diagnosis includes severe back pain, short term memory loss, ~d osteoporosis. 's assessment states domestic assistance is required weekly.

o HCP Level 2 assessment completed 15 November 2018; date of diagnosis included a . -

s assessment states domestic assistance is required but is currently 'on h d' at the re uest of •son.

o CP Level 3 assessment com leted 15 November 2018; date of multiple fractures, falls,

self manages ADLs, currently seeing specialist for unconscious collapses.

s ssessment states check visits are required three times weekly. o HCP Level 2 assessment including a Home safety

assessment completed 23 November 2018; date of birth diagnosis includes left fracture.years ago. 's assessment states domestic ~ire.

o ----HCP Level 2 assessment includin a Home safety assessment com leted 23 November 2018 date of birth dia nosis includes

Two falls in the past 12 months. assistance is required.

o HCP Level 3 a~ted 20 November 2018; date of birth diagnosis~ --s assessment states

c eaning, garaening, and assistance to walkarowidblock is required for two hours twice weekly.

o HCP Level 3 assessment completed 21 November 2018, date of diagnosis lower back pain, previous fracture of hip, arthritis in

October 2016 goal 'home support'. Lives alone, no family support, difficulty with jobs due to back pain, struggles ~cuments, some anxiety over Home Assist care bills, recent falls. --assessment states assistance is required with cleaning and hanging out washing fortnightly.

o HCP Level 2 assessment completed 22 November 2018; date diagnosis ith recent

hospital a m1ss1on, alance issues walking frame and shower chair, no falls. Lives alone. assessment states assistance is required with shopping fortnightly. The assessment also states that quotes for gardening are being sourced.

The service does not have effective monitoring processes for this expected outcome.

• The service's self-assessment did not identify care recipients' assessments had not been undertaken at the time of commencement of services, in line with Consumer directed care processes.

• The Director said she had not fully understood Home care package requirements at the time these care recipients commenced services and a processes to monitor assessments has not been developed because i-·-·-·-·-·-·-B-D._Pty-i:-icf-·-·-·-·-·-!does not intend to remain as an approved provider. ··-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·'

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Expected outcome 2.2 - Assessment I Not met

Staff interviewed said they did not receive documented information about clients until recently.

• All staff interviewed said they did not have access to care plans or documentation outlining care recipients care needs and services until recently. They now have information available on a telephone App and care recipients have information within their homes.

Care recipients interviewed said they remember having a :·-·-·-·-·-·-·-·-s[f Pty_i._tcf-·-·-·-·-·-·-·-i representative visit their home when commencing but none-·cauTd-rememoefffavlrig a formal assessment completed until recently.

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• Both care recipients and the representative interviewed said they recall having a representative from [~~~~~~~~~~~~~~~~)~i?.~¥.!Y~~~t-~~~~~~~~~~~~~~~~Jvisit them when commencing services. They thought that this visit had probably included an informal assessment of their care _Q?.§9.?._.§l_Q_g __ ?.§~.i-~~ requirements. They said they had been visited recently by lii.i:i~~i~!ciJ [_·-·----~-~--~~~--'=~~----·-·-·!staff and had definitely participated in an assessment at this visit. They all said they have been given a lot of information recently and were g§l_ttlO.Q ____ _ confused but felt sure they had received either a care or service plan from l_s_°.._~ty_L_t_~.i

[~~~~Ei..!5-~~~¥.~~~~~~~~J

Expected outcome 2.3 - Care plan development and delivery Not met

The expected outcome requires that "each service user and/or their representative, participates in the development of a care/service plan that is based on assessed needs and is provided with the care and/or services described in their plan".


L~~~~~~~~~~~~~~~~~~~~¥I!~~~~~~~~~~~~~Jcare recipients were not provided care plans based on assessed needs within 14 days of commencing services. Care plans lack details, there are no individual goal statements and plans have not always been accessible to care recipients or the support workers. The service does not have effective monitoring processes for this expected outcome. Both care recipients and representative interviewed said that while they met with the Director on commencement with i-·-·-·-·-·-·-·-·-13·[f.Ptyi.tci-·-·-·-·-·-·-·-·-~ they had not been provided with a care plan outlining their agreecrs·ervTces·-un-tff"rece·nu~T··


L~--~--~--~--~--~--~--~8-.~--~~!i"J:I~·-~--~--~--~--~--~·.Jcare recipients were not provided care plans based on assessed needs within 14 days of commencing services.

• We viewed the files of the ten care recipients who commenced ati-·-·-·-·130-·Pty-Ltd-·-·-·-·: :·00-Pty.i:t"ci-i between 1 October 2018 and 15 October 2018. The DireCfO"r·-salcftfl·e-·c-,ire '·-recfpfe"ilts were receiving services from commencement but they were not provided with care plans, service plans or budget statements before mid-November 2018.

• All ten files included a service plan which stated the name of the care worker, the service to be provided and the da , time and duration of the service/s. Bud et statements for care recipients sighted included services which matched the services described within their care plans.

• Nine of the 10 files contained a care plan. The care plans stated the services care recipients were receiving and these services were based on the care recipients' assessed needs. All nine care plans were signed by the RN but not dated:

o HCP Level 3 - care plan states assistance is provided for

0

activities of daily living, shopping and guidance with cooking two hours, five days a week.

HCP Level 2 - care plan states assistance is provided with

Name of home service: l~--~--~--~--~--~·.:·.~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~!i~P.:iX.·.~~d~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~--~·.J Date of quality review: 21 December 2018

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showering five times a week o HCP Level 3 - care plan states domestic assistance is provided

weekly. o HCP Level 2 - care plan states cleaning currently on hold. o HCP Level 3 care plan states assistance is provided with cleaning

and hanging out washing fortnightly. o HCP Level 2 - care plan states gardening assistance is

provided. o HCP Level 3 - care plan states assistance is provided with cleaning and

-

. t th shing fortnightly. o HCP Level 2 - care plan states fortnightly assistance is

provided with shopping. o HCP Level 3 - care plan states check visits are provided three

times weekly. • One of the 1 O files contained no care plan.

o HCP Level 2 - had a service plan but no care plan in her file. The service plan states cleaning is provided.

Care plans lack details, there are no individual goal statements and plans have not always been accessible to care recipients or the support workers.

• Care plans state actions for services but do not always contain sufficient information to guide support workers. For example and~, care plans state they receive cleaning but there are no instructions about ~ces, equipment or products. 's care plan states he receives gardening but doesn't alert the care worker to his history of falls.

• None of the nine care plans sighted include individual goal statements in relation to the different aspects of the care recipients' life.

The service does not have effective monitoring processes for this expected outcome

• [~~~~~~~~~~[[E~i~L;~Cf~~~~~~~Jself-assessment did not identify care recipients' care plans had not been undertaken in line with Consumer directed care processes.

• The Director said she had not fully understood Home care package requirements at the time these care recipients commenced and no other processes are in place to monitor care plan development and service delivery.

All care recipients interviewed said that while they met with the Director on commencement ~i!hL~~~~~~~~~~~~~~~§~~!i~~-t~~~~~~~~~~~~~~~J, they were not provided a care plan outlining their agreed services until recently.

• Both care recipients and the representative interviewed said they are receiving the services that meet th.~jf._§§>Sessed needs. They have been receiving lots information in the past month from l._~_q ___ !and also from their pending providers. They have been involved in discussions about transitional arrangements and have signed agreements with new providers and have been assured their services will be ongoing and provided by current care staff. They said they have been given a lot of information recently and were getting confused but felt sure they had received either a care and/or service plan

from f:~:~:~:~:~:~:~:~.~:~:~Y.~:~t~:~:~:~:~:~:~J Additional information

• All staff interviewed said they now have information about care recipients' needs and services requirements. They access this information via a telephone App and are also provided additional information as required by telephoning the Director.

• The Director confirmed care recipients have been informed about services over the holiday period. They have been informed services would not be provided on Christmas

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Day; but will resume as normal after that. They have the Director's telephone number if assistance is required. These conversations have not been recorded in progress notes.

Service provision over Christmas: • The Director said no services will be provided on Christmas Day and confirmed

ongoing services will then resume. • Ten files viewed (and in discussion with Director) show no medication administration or

wound care provided is currently provided. • The following seven of the 10 care recipients are currently receiving weekly to

fortnightly cleaning, gardening, shopping and/or transport services and will not be affected by the Christmas holiday.

0

0

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0

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0

• Three people have personal care assistance and/or check visits up to five times a week. We asked the Director what services and arrangements were in place for these care recipients' services for Christmas day:

o - checking if help required with ADLs, two hours Monday to will be staying with family over Christmas.

o - stand-by assistance with showering, one hour five times week. Mrs is recovering from recent hospital admission following a fractured ankle. RN assessments occurred • November 2018 (while in hospital) and again 17 December 2018 (at home) to assess progress. Mrs .. lives with her husband. She is improving and has requested not to have services Christmas Day or other public holidays.

o - check visits three times weekly. Son from interstate is staying with her over Christmas.

• Both care recipients and the representative interviewed said they have had discussions, understand and are satisfied with service provision arrangements over Christmas holidays.

Expected outcome 2.4 - Service user reassessment I Not met

The expected outcome requires that "each service user's needs are monitored and regularly reassessed taking into account any relevant program guidelines and in accordance with the complexity of the service user's needs. Each service users' care/service plans are reviewed in consultation with them".


i-·-·-·-·-·-·-·-·-95·Pty.ij(j"-·-·-·-·-·-·-·-·!does not ensure care recipient needs are monitored and regularly '-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-·-· reassessed in accordance with the complexity of the service user's needs. Care recipients did not receive reassessments which had been scheduled to occur two weeks after the initial care plan had been developed. The self-assessment did not address reassessment requirements or how the service monitors compliance with this expected outcome. Care recipients and the representative interviewed said they participated in an assessment but no have not participated in any reassessments at this stage.

Care recipients did not receive the reassessments which had been scheduled to occur two

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Expected outcome 2.4 - Service user reassessment I Not met

weeks after their initial assessment.

• All 10 care recipients entered the service between 1 October 2018 and 15 October 2018; however, none were assessed until mid-November 2018. Refer to Expected outcome 2.2 Service user assessment.

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• The nine care plans (undated) sighted show a new reassessment date scheduled to occur two weeks after the initial mid to late November assessment and were therefore all overdue.

• We did not see any of the scheduled reassessments in the care recipients' files. The Director said that while she was aware the reassessment dates had been set; these reassessments had not been undertaken.

The service does not have effective monitoring processes for this expected outcome. The self-assessment did not address the requirements on how the service monitors compliance with this expected outcome.

• The Director said they have not developed a process to monitor the reassessments as they no longer intend to be an approved provider.

Care recipients and the representative interviewed said they participated in an assessment but have not participated in any reassessments at this stage.

o Both care recipients and representative interviewed said they had not discussed reassessments with r_~--~~6-·J.

Expected outcome 2.5 - Service user referral Not met

The expected outcome requires that "the service provider refers service users (and/or their representatives) to other providers as appropriate".


[~~~~~~~~~~[[E~i~L;~Cf~~~~~~~Jwere unable to demonstrate effective referral of care recipients to other health and allied health specialists. The self-assessment did not address the requirements on how the service monitors compliance with this expected outcome. All care recipients interviewed said they were satisfied with how their current transfer arrangements were being conducted however they were unsure about referral processes to specialists and other health specialists.


L.~.~-~-~-~-~-~-~Q~_l'._fi.1If.~.~-~-~-~.J were unable to demonstrate effective referral of care recipients to other health and allied health specialists.

• assessment on 21 November 2018 indicates a physiotherapy referral is required however we did not see evidence that this referral had been actioned.

• The Director was unable to demonstrate that they had assisted care recipient Mr with referral back to My Aged Care or other service providers. See

expected outcome 1.1 corporate governance.

• The Director stated they now have a process for transferring care recipients to another service provider; however, they have not developed a process for referral of care recipients to other allied or health specialists.


• The Director said she had not fully understood Home care package requirements at the

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Expected outcome 2.5 - Service user referral I Not met

time these care recipients were admitted into the service and the service has not developed processes to monitor referrals as they no longer intend to be an approved provider.

All care recipients interviewed said they had been unsure about referral processes but were satisfied with how their transfer arrangements were being conducted.

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• All care recipients and the representative interviewed said they had recently received transfer information and were satisfied with the assistance provided to them to access another service provider; however, they were unsure about other referral processes such as to allied health professionals.

Expected outcome 3.1 - Information provision I Met

The expected outcome requires that "each service user, or prospective service user, is provided with information (initially and on an ongoing basis) in a format appropriate to their needs to assist them to make service choices and gain an understanding of the services available to them and their rights and responsibilities".

Reasons for findings for home care services:

Care recipients have been provided with information to assist them to make service choices and gain an understanding of the services available to them and their rights and responsibilities. The services new client policy now states 'When commencing with the service, clients are to be provided with information on services available, fees, advocacy, complaints and rights and responsibilities'.

Documentation provided at the site visit shows that since the assessment contact visit on 31 October 2018 management have developed a plan for the transfer of care recipients to other providers. All care recipients have been provided with written information advising of the management decision to no longer provide HCP. Other information provided to care recipients included a list of other local HCP service providers, the Charter of rights and responsibilities, advocacy services and complaints commission details; the Director advised, and care recipients interviewed confirmed, the Director has meet with each care recipient to discuss their options. Once a new provider has been chosen an individual transition plan is developed in consultation with the care recipient and the new provider. Individual plans outline the date of the initial meeting with the new provider, the date the agreement to transfer is signed, the date the new provider will take responsibilities for the care recipient and the amount of funds to be transferred.


• Care recipients interviewed said management have meet with them and they have been provided information on what is happening and assistance in understanding their options.

• All staff interviewed were aware of the decision by management to no longer provider HCP services and said they have been consulted about their options.

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Expected outcome 3.2 - Privacy and confidentiality I Not met

The expected outcome requires that "each service user's right to privacy, dignity and confidentiality is respected including in the collection, use and disclosure of personal information".


The service could not demonstrate care recipients' right to privacy, dignity and confidentiality is respected including in the collection, use and disclosure of personal information. Care recipients have not been asked to sign release of information agreements. Staff confidentially agreements only refer to the providers business interests.


Care recipients have not been asked to sign release of information agreements.

• Management advised care recipients' have not been asked to sign a consent form for the release and collection of information. Management said they do this however, this is not recorded anywhere.

• All care recipients interviewed said they could not remember being provided with any information in relation to privacy and confidentiality including on the collection, use and disclosure of personal information on commencement of the service verbally;

Staff confidentially agreements only refer to the providers business interests.

• Staff confidentiality agreements reviewed show staff sign a confidentiality agreement; however, these agreements only refer to the provider's information.


• Care recipients information is stored securely in locked cabinets and computers are password protected.

• Staff interviewed described process to ensure privacy and confidentiality is maintained.

• Care recipients interviewed said they are treated with respect.

Expected outcome 3.3 - Complaints and service user feedback I Met

The expected outcome requires that "complaints and service user feedback are dealt w ith fairly, promptly, confidentially and without retribution".


Complaints and care recipient feedback is dealt with fairly, promptly, confidentially and without retribution. The services new client policy now states 'When commencing with the service, clients are to be provided with information on services available, fees, advocacy, complaints and rights and responsibilities'.

Documentation provided at the site visit shows that since the assessment contact visit on 31 October 2018 management have provided care recipients with written information on advocacy services, the services complaints process and the complaints commission details.

A review of the complaints register shows the two issues raised were resolved in a timely manner. Staff described how they manage complaints, which was consistent with the services policy. Care recipients interviewed said they would feel comfortable raising issues with the Director.

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Expected outcome 3.3 - Complaints and service user feedback Met


• The director advised they are aware they did not follow the correct procedure when addressing Mr - s complaints about termination of his services and have since tried to rectify the"Sit'Uation. A formal letter of termination was sent to Mr by the provider on 23 October 2018 and his details have been referred back to My Aged Care.

• Documentation provided at the site visit shows both the Aged Care Complaints Commissioner and the Pol ice have investigated claims made by Mr - s about his termination and are taking no further action.

Expected outcome 3.4 - Advocacy I Met

The expected outcome requires that "each service user's (and/or their representative's) choice of advocate is respected by the service provider and the service provider will, if required, assist the service user (and/or their representative) to access an advocate".

Reasons for findings for home care services:

The service provider has processes for recognising and respecting care recipients' choice of advocate. The services new client policy now states 'When commencing with the service, clients are to be provided with information on services available, fees, advocacy, complaints and rights and responsibilities'. Information on care recipients' representatives is recorded on the electronic database and can also be accessed from the My Aged Care portal if required. Staff interviewed said they are aware of care recipients' right to appoint an advocate of their choice and advocate information is identified, where relevant, via the mobile phone app. Care recipients said they are satisfied their representatives are included and consulted when required.

Expected outcome 3.5- Independence I Not met

The expected outcome requires that "the independence of service users is supported, fostered and encouraged".


The service does not ensure the independence of care recipients is supported, fostered and encouraged. Care recipients do not have consumer directed care plans. Staff do not support, foster and encourage care recipients' to set goals in relation to the different aspects of their life, for example physical , intellectual and emotional. The service does not have effective monitoring processes for this expected outcome. The self-assessment did not address the requirements on how the service monitors compliance with this expected outcome. All care recipients interviewed said the services provided allow provided them to remain in their homes.


The service does not ensure the independence of care recipients is supported, fostered and encouraged.

• The Charter of care recipients' rights and responsibilities-home care states under Consumer Directed Care - choice and flexibility (2) (a) (i) "Each care recipient has the [right] to be supported by the approved provider: to set goals in relation to the outcomes he or she seeks from home care.

• The Home Care Agreement outlines the requirements of developing a care plan. Referenced in Part C. Care Plan and Budget which outlines in 4.1 You acknowledge that prior to the date of the Agreement, !'sol has met with you to discuss your care

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Expected outcome 3.5 - Independence Not met

needs and develop the Care Plan based on: o 4.1.1 your Home Care Package Level o 4.1.2 your goals

• The care plans show care recipients have not been supported to set goals in line with The Charter of care recipients' rights and responsibilities-home care or the f"ii[J"1 Home Care Agreement. ; _________ .;

Staff do not support, foster and encourage care recipients' to set goals in different aspects of their life, for example physical, intellectual and emotional.

• Eight of the ten care recipients' files viewed contained a care plan but none of these plans included a goal statement:

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• The Director said they have not developed goal statements, nor have they developed a process to monitor care recipients' independence as they no longer intend to be an approved provider.

Care recipients stated the services provided allow them to remain in their homes.

• Both care recipients and the representative interviewed said services such as gardening, cleaning and other assistance helps them to maintain their independence.

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Australian Government - agedcare.royalcommission.gov.au · Aged Care Quality and Safety Commission...

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Transcript of Australian Government - agedcare.royalcommission.gov.au · Aged Care Quality and Safety Commission...