A Practical Approach to Preparing and Achieving Accreditation in Home Care

Anglican Care Community Care Services has recently undergone Quality Review in 2016 in two out of the three regions we operate. As a major provider of community care services, across all four Home Care Package levels, in addition to a suite of Commonwealth Home Support Programs, including centre based services, the anticipation of quality review, and the work required to prepare for review, was a little daunting, particularly with the additional workload associated with the aged care reforms. Anglican Care, like many organisations has implemented new client and business management systems to enable us to work more efficiently and effectively in the consumer directed care environment.

We supported all of our staff to participate in the two-day Understanding Quality Review Course delivered by the Quality Agency in early 2016, just prior to our first review. Our organisation had previously participated in quality training, and has had significant experience in quality review processes, including our application of external quality management systems such as QPS Benchmarking. The training provided by the Agency was engaging and thought provoking. We knew staff were slightly hesitant, given the perception of the ‘dryness’ of the topic, but we can honestly say it was one of the most engaging and informative training sessions we had participated in for some time.

The training provided staff with practical ideas and best practice examples to apply to their everyday work processes. It supported them to think about quality in a more dynamic way, and encouraged them to lead their own quality improvement path within the broader work of Anglican Care. Staff reported feeling more confident about the focus on improvement rather than an audit style approach. They were also provided with relevant resource material that they could continue to refer to.

Our staff participated in the implementation of QPS Benchmarking across all regions in which we operate enabling them to better understand how the various self-assessments, audits, skills knowledge competencies and stakeholder surveys support the organisation in our endeavour to improve systems and practices. Targeted education such as Putting the Business into your Home Care Services also provided the managers and case managers with a greater understanding of the transition to consumer directed care and practices that enable older people and their carers to exercise choice and control over their services. The QPS Benchmarking framework is a great way of ensuring these practices are translated into documented evidence and a clear understanding of performance.

Our first review took place within our Central Coast region. We were well prepared, having completed the self-assessment tool and plan for continuous improvement prior to the site visit. We had worked with the team to ‘self-audit’ and identify areas of improvement. This process was useful, and highlighted to us where there were areas of inconsistency within and between different areas of the business. We realised that even when we were confident that the quality of the work was high, if there was a lack of consistent documentation practice, or difficulty in finding key documents, this level of quality was difficult to demonstrate. We prepared an evidence folder with links to key documents and provided the reviewers with access to our electronic systems and assisted the assessors to navigate the various databases.

Our second review, in our Hunter region, involved concurrent reviews of both our home care package (HCP) program and the Commonwealth Home Support Programs (CHSP) including three centre-based services. Consequently, this review was significantly more extensive, both in preparation for us, and execution by the Agency. Again, we identified through self-audits, and as a result of the review, an opportunity to provide more training and guidance in consistent assessments and care planning processes: specifically, the use of standardised tools. This continues to be a positive experience for us as we work towards our goal for the standardised implementation of validated tool sets across all areas of our community care practice. We have also invested in staff and systems development to embed restorative approaches in our HCP and CHSP service delivery which was acknowledged by the reviewers.

Quality Agency staff were positive, and provided meaningful feedback through observation and paper audits. We felt that in comparison to previous years’ review processes, the ones under the Agency have been more operational and practical than administrative, which has enabled more ‘real’ opportunity for us as an organisation to implement quality improvements throughout the preparation, audit, and post-audit phases of the process. Agency personnel engaged with staff, consumers and carers, through their ‘triangulated’ review methodology, which not only provided more comprehensive information about our work, but also provided participants with a real and important role in defining and evaluating quality through their work with, and receipt of care through, our organisation. Our organisation met all Standards and Expected Outcomes at the quality reviews and are working towards this same outcome in future reviews.

We encourage other organisations to invest in this process using a team and organisational approach, and make the most of the opportunity to self-audit and build understanding about practical, operational quality principles and their application to not only their work, but to the outcomes experienced by the consumers of their services. The quality review is also a great opportunity to inform the Board and broader organisation of the achievements with your community care services.

Helen Bartley, Manager Community Care Services high-fiving Consumer John Nicholls

Chris Giles, General Manager Community Care Services, Anglican Care