Note:  Part 4.1 of the Aged Care Act 1997

Part 4.1 of the Aged Care Act 1997 is about the responsibilities of approved providers for the quality of the aged care they provide through their aged care services.

The responsibilities of approved providers include compliance with a number of standards set out in these Principles.  The standards are:

·           the Accreditation Standards

·           the Residential Care Standards

·           the Community Care Standards

·           the Flexible Care Standards.

Note:  Definitions

A number of expressions used in these Principles are defined in the Aged Care Act 1997 (see Dictionary in Schedule 1), including:

·           accreditation day

·           aged care

·           approved provider

·           community care

·           flexible care

·           key personnel

·           residential care.

1.1

Administration

General operation of the residential care service, including resident documentation

1.2

Maintenance of buildings and grounds

Adequately maintained buildings and grounds

1.3

Accommodation

Utilities such as electricity and water

1.4

Furnishings

Bed‑side lockers, chairs with arms, containers for personal laundry, dining, lounge and recreational furnishings, draw‑screens (for shared rooms), resident wardrobe space, and towel rails

Excludes furnishings a resident chooses to provide

1.5

Bedding

Beds and mattresses, bed linen, blankets, and absorbent or waterproof sheeting

1.6

Cleaning services, goods and facilities

Cleanliness and tidiness of the entire residential care service

Excludes a resident’s personal area if the resident chooses and is able to maintain it himself or herself

1.7

Waste disposal

Safe disposal of organic and inorganic waste material

1.8

General laundry

Heavy laundry facilities and services, and personal laundry services, including laundering of clothing that can be machine washed

Excludes cleaning of clothing requiring dry cleaning or another special cleaning process, and personal laundry if a resident chooses and is able to do this himself or herself

1.9

Toiletry goods

Bath towels, face washers, soap, and toilet paper

1.10

Meals and refreshments

(a)   Meals of adequate variety, quality and quantity for each resident, served each day at times generally acceptable to both residents and management, and generally consisting of 3 meals per day plus morning tea, afternoon tea and supper

(b)   Special dietary requirements, having regard to either medical need or religious or cultural observance

(c)   Food, including fruit of adequate variety, quality and quantity, and non‑alcoholic beverages, including fruit juice

1.11

Resident social activities

Programs to encourage residents to take part in social activities that promote and protect their dignity, and to take part in community life outside the residential care service

1.12

Emergency assistance

At least 1 responsible person is continuously on call and in reasonable proximity to render emergency assistance

2.1

Daily living activities assistance

Personal assistance, including individual attention, individual supervision, and physical assistance, with:

(a)   bathing, showering, personal hygiene and grooming

(b)   maintaining continence or managing incontinence, and using aids and appliances designed to assist continence management

(c)   eating and eating aids, and using eating utensils and eating aids (including actual feeding if necessary)

(d)   dressing, undressing, and using dressing aids

(e)   moving, walking, wheelchair use, and using devices and appliances designed to aid mobility, including the fitting of artificial limbs and other personal mobility aids

(f)    communication, including to address difficulties arising from impaired hearing, sight or speech, or lack of common language (including fitting sensory communication aids), and checking hearing aid batteries and cleaning spectacles

Excludes hairdressing

2.2

Meals and refreshments

Special diet not normally provided

2.3

Emotional support

Emotional support to, and supervision of, residents

2.4

Treatments and procedures

Treatments and procedures that are carried out according to the instructions of a health professional or a person responsible for assessing a resident’s personal care needs, including supervision and physical assistance with taking medications, and ordering and reordering medications, subject to requirements of State or Territory law

2.5

Recreational therapy

Recreational activities suited to residents, participation in the activities, and communal recreational equipment

2.6

Rehabilitation support

Individual therapy programs designed by health professionals that are aimed at maintaining or restoring a resident’s ability to perform daily tasks for himself or herself, or assisting residents to obtain access to such programs

2.7

Assistance in obtaining health practitioner services

Arrangements for aural, community health, dental, medical, psychiatric and other health practitioners to visit residents, whether the arrangements are made by residents, relatives or other persons representing the interests of residents, or are made direct with a health practitioner

2.8

Assistance in obtaining access to specialised therapy services

Making arrangements for speech therapy, podiatry, occupational or physiotherapy practitioners to visit residents, whether the arrangements are made by residents, relatives or other persons representing the interests of residents

2.9

Support for residents with cognitive impairment

Individual attention and support to residents with cognitive impairment (eg dementia, and other behavioural disorders), including individual therapy activities and specific programs designed and carried out to prevent or manage a particular condition or behaviour and to enhance the quality of life and care for such residents and ongoing support (including specific encouragement) to motivate or enable such residents to take part in general activities of the residential care service

3.1

Furnishings

Over‑bed tables

3.2

Bedding materials

Bed rails, incontinence sheets, restrainers, ripple mattresses, sheepskins, tri‑pillows, and water and air mattresses appropriate to each resident’s condition

3.3

Toiletry goods

Sanitary pads, tissues, toothpaste, denture cleaning preparations, shampoo and conditioner, and talcum powder

3.4

Goods to assist residents to move themselves

Crutches, quadruped walkers, walking frames, walking sticks, and wheelchairs

Excludes motorised wheelchairs and custom made aids

3.5

Goods to assist staff to move residents

Mechanical devices for lifting residents, stretchers, and trolleys

3.6

Goods to assist with toileting and incontinence management

Absorbent aids, commode chairs, disposable bed pans and urinal covers, disposable pads, over‑toilet chairs, shower chairs and urodomes, catheter and urinary drainage appliances, and disposable enemas

3.7

Basic medical and pharmaceutical supplies and equipment

Analgesia, anti‑nausea agents, bandages, creams, dressings, laxatives and aperients, mouthwashes, ointments, saline, skin emollients, swabs, and urinary alkalising agents

Excludes goods prescribed by a health practitioner for a particular resident and used only by the resident

3.8

Nursing services

Initial and on‑going assessment, planning and management of care for residents, carried out by a registered nurse

Nursing services carried out by a registered nurse, or other professional appropriate to the service (eg medical practitioner, stoma therapist, speech pathologist, physiotherapist or qualified practitioner from a palliative care team)

Services may include, but are not limited to, the following:

(a)   establishment and supervision of a complex pain management or palliative care program, including monitoring and managing any side effects

(b)   insertion, care and maintenance of tubes, including intravenous and naso‑gastric tubes

(c)   establishing and reviewing a catheter care program, including the insertion, removal and replacement of catheters

(d)   establishing and reviewing a stoma care program

(e)   complex wound management

(f)    insertion of suppositories

(g)   risk management procedures relating to acute or chronic infectious conditions

(h)   special feeding for care recipients with dysphagia (difficulty with swallowing)

(i)    suctioning of airways

(j)    tracheostomy care

(k)   enema administration

(l)    oxygen therapy requiring ongoing supervision because of a care recipient’s variable need

(m)  dialysis treatment

3.10

Medications

Medications subject to requirements of State or Territory law

3.11

Therapy services, such as, recreational, speech therapy, podiatry, occupational, and physiotherapy services

(a)   Maintenance therapy delivered by health professionals, or care staff as directed by health professionals, designed to maintain residents’ levels of independence in activities of daily living

(b)   More intensive therapy delivered by health professionals, or care staff as directed by health professionals, on a temporary basis that is designed to allow residents to reach a level of independence at which maintenance therapy will meet their needs

Excludes intensive, long‑term rehabilitation services required following, for example, serious illness or injury, surgery or trauma

3.12

Oxygen and oxygen equipment

Oxygen and oxygen equipment needed on a short‑term, episodic or emergency basis

1.1

Continuous improvement

The organisation actively pursues continuous improvement

1.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards and guidelines

1.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

1.4

Comments and complaints

Each resident (or his or her representative) and other interested parties have access to internal and external complaints mechanisms

1.5

Planning and leadership

The organisation has documented the residential care service’s vision, values, philosophy, objectives and commitment to quality throughout the service

1.6

Human resource management

There are appropriately skilled and qualified staff sufficient to ensure that services are delivered in accordance with these standards and the residential care service’s philosophy and objectives

1.7

Inventory and equipment

Stocks of appropriate goods and equipment for quality service delivery are available

1.8

Information systems

Effective information management systems are in place

1.9

External services

All externally sourced services are provided in a way that meets the residential care service’s needs and service quality goals

2.1

Continuous improvement

The organisation actively pursues continuous improvement

2.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards, and guidelines, about health and personal care

2.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

2.4

Clinical care

Residents receive appropriate clinical care

2.5

Specialised nursing care needs

Residents’ specialised nursing care needs are identified and met by appropriately qualified nursing staff

2.6

Other health and related services

Residents are referred to appropriate health specialists in accordance with the resident’s needs and preferences

2.7

Medication management

Residents’ medication is managed safely and correctly

2.8

Pain management

All residents are as free as possible from pain

2.9

Palliative care

The comfort and dignity of terminally ill residents is maintained

2.10

Nutrition and hydration

Residents receive adequate nourishment and hydration

2.11

Skin care

Residents’ skin integrity is consistent with their general health

2.12

Continence management

Residents’ continence is managed effectively

2.13

Behavioural management

The needs of residents with challenging behaviours are managed effectively

2.14

Mobility, dexterity and rehabilitation

Optimum levels of mobility and dexterity are achieved for all residents

2.15

Oral and dental care

Residents’ oral and dental health is maintained

2.16

Sensory loss

Residents’ sensory losses are identified and managed effectively

2.17

Sleep

Residents are able to achieve natural sleep patterns

3.1

Continuous improvement

The organisation actively pursues continuous improvement

3.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards, and guidelines, about resident lifestyle

3.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

3.4

Emotional support

Each resident receives support in adjusting to life in the new environment and on an ongoing basis

3.5

Independence

Residents are assisted to achieve maximum independence, maintain friendships and participate in the life of the community within and outside the residential care service

3.6

Privacy and dignity

Each resident’s right to privacy, dignity and confidentiality is recognised and respected

3.7

Leisure interests and activities

Residents are encouraged and supported to participate in a wide range of interests and activities of interest to them

3.8

Cultural and spiritual life

Individual interests, customs, beliefs and cultural and ethnic backgrounds are valued and fostered

3.9

Choice and decision‑making

Each resident (or his or her representative) participates in decisions about the services the resident receives, and is enabled to exercise choice and control over his or her lifestyle while not infringing on the rights of other people

3.10

Resident security of tenure and responsibilities

Residents have secure tenure within the residential care service, and understand their rights and responsibilities

4.1

Continuous improvement

The organisation actively pursues continuous improvement

4.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards, and guidelines, about physical environment and safe systems

4.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

4.4

Living environment

Management of the residential care service is actively working to provide a safe and comfortable environment consistent with residents’ care needs

4.5

Occupational health and safety

Management is actively working to provide a safe working environment that meets regulatory requirements

4.6

Fire, security and other emergencies

Management and staff are actively working to provide an environment and safe systems of work that minimise fire, security and emergency risks

4.7

Infection control

An effective infection control program

4.8

Catering, cleaning and laundry services

Hospitality services are provided in a way that enhances residents’ quality of life and the staff’s working environment

1.1

Continuous improvement

The organisation actively pursues continuous improvement

1.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards, and guidelines, about health and personal care

1.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

1.4

Clinical care

Residents receive appropriate clinical care

1.5

Specialised nursing care needs

Residents’ specialised nursing care needs are identified and met by appropriately qualified nursing staff

1.6

Other health and related services

Residents are referred to appropriate health specialists in accordance with the resident’s needs and preferences

1.7

Medication management

Residents’ medication is managed safely and correctly

1.8

Pain management

All residents are as free as possible from pain

1.9

Palliative care

The comfort and dignity of terminally ill residents is maintained

1.10

Nutrition and hydration

Residents receive adequate nourishment and hydration

1.11

Skin care

Residents’ skin integrity is consistent with their general health

1.12

Continence management

Residents’ continence is managed effectively

1.13

Behavioural management

The needs of residents with challenging behaviours are managed effectively

1.14

Mobility, dexterity and rehabilitation

Optimum levels of mobility and dexterity are achieved for all residents

1.15

Oral and dental care

Residents’ oral and dental health is maintained

1.16

Sensory loss

Residents’ sensory losses are identified and managed effectively

1.17

Sleep

Residents are able to achieve natural sleep patterns

2.1

Continuous improvement

The organisation actively pursues continuous improvement

2.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards, and guidelines, about resident lifestyle

2.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

2.4

Emotional support

Each resident receives support in adjusting to life in the new environment and on an ongoing basis

2.5

Independence

Residents are assisted to achieve maximum independence, maintain friendships and participate in the life of the community within and outside the residential care service

2.6

Privacy and dignity

Each resident’s right to privacy, dignity and confidentiality is recognised and respected

2.7

Leisure interests and activities

Residents are encouraged and supported to participate in a wide range of interests and activities of interest to them

2.8

Cultural and spiritual life

Individual interests, customs, beliefs and cultural and ethnic backgrounds are valued and fostered

2.9

Choice and decision‑making

Each resident (or his or her representative) participates in decisions about the services the resident receives, and is enabled to exercise choice and control over his or her lifestyle while not infringing on the rights of other people

2.10

Resident security of tenure and responsibilities

Residents have secure tenure within the residential care service, and understand their rights and responsibilities

3.1

Continuous improvement

The organisation actively pursues continuous improvement

3.2

Regulatory compliance

The organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards, and guidelines, about physical environment and safe systems

3.3

Education and staff development

Management and staff have appropriate knowledge and skills to perform their roles effectively

3.4

Living environment

Management of the residential care service is actively working to provide a safe and comfortable environment consistent with residents’ care needs

3.5

Occupational health and safety

Management is actively working to provide a safe working environment that meets regulatory requirements

3.6

Fire, security and other emergencies

Management and staff are actively working to provide an environment and safe systems of work that minimise fire, security and emergency risks

3.7

Infection control

An effective infection control program

3.8

Catering, cleaning and laundry services

Hospitality services are provided in a way that enhances residents’ quality of life and the staff’s working environment

1.1

Assistance

Each prospective care recipient (or his or her representative) is assisted to make informed choices about the community care services

1.2

Rights and responsibilities

Each care recipient and prospective care recipient (or his or her representative) is informed of the rights and responsibilities of care recipients and approved providers in relation to community care services, and given the opportunity to discuss with the provider the recipient’s rights and responsibilities

1.3

Fees

Each care recipient and prospective care recipient (or his or her representative) is assisted to understand the fees applying to services

Col. 1

Item

Column 2

Matter Indicator

Column 3

Expected Outcome

2.1

Identifying care needs

Each care recipient receives an initial assessment and on‑going monitoring that takes all of his or her support needs into account and identifies any changes in the needs

3.1

Service delivery plan

Each care recipient has a documented service delivery or care plan outlining the services the care recipient can expect to receive

3.2

Referral arrangements

Each care recipient benefits from the establishment of appropriate referral arrangements to ensure continuity in best meeting his or her needs when community care services are no longer appropriate

Col. 1

Item

Column 2

Matter Indicator

Column 3

Expected Outcome

4.1

Social independence

Each care recipient is encouraged to exercise his or her preferred level of social independence

4.2

Financial independence

Each care recipient is encouraged to maintain financial independence

Col. 1

Item

Column 2

Matter Indicator

Column 3

Expected Outcome

5.1

Privacy and dignity

Each care recipient’s dignity and privacy is respected

5.2

Procedures

Each care recipient is told of the service provider’s privacy and confidentiality procedures and his or her rights under the procedures

5.3

Access to information

Each care recipient (or his or her representative) has access to personal information about the care recipient held by the approved provider

Col. 1

Item

Column 2

Matter Indicator

Column 3

Expected Outcome

6.1

Complaint procedures

Each comment or complaint about a service, or access to a service, is dealt with fairly, promptly, confidentially and without retribution

Col. 1

Item

Column 2

Matter Indicator

Column 3

Expected Outcome

7.1

Choice of advocate

The care recipient’s choice and involvement of an advocate to represent his or her interests at any time is accepted by the approved provider

1.1

Corporate governance

The service provider has implemented corporate governance processes that are accountable to stakeholders.

1.2

Regulatory compliance

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

1.3

Information management systems

The service provider has effective information management systems in place.

1.4

Community understanding and engagement

The service provider understands and engages with the community in which it operates and reflects this in service planning and development. 

1.5

Continuous improvement

The service provider actively pursues and demonstrates continuous improvement in all aspects of service management and delivery.

1.6

Risk management

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

1.7

Human resource management

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

1.8

Physical resources

The service provider manages physical resources to ensure the safe delivery of care and services to service users and organisation personnel.

Col. 1

Item

Column 2

Matter Indicator

Column 3

Expected Outcome

2.1

Service access

Each 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.

2.2

Assessment

Each service user participates in an assessment appropriate to the complexity of their needs and with consideration of their cultural and linguistic diversity.

2.3

Care plan development and delivery

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.

2.4

Service user reassessment

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 user’s care/service plans are reviewed in consultation with them.

2.5

Service user referral

The service provider refers service users (and/or their representative) to other providers as appropriate.

3.1

Information provision

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.

3.2

Privacy and confidentiality

Each service user’s right to privacy, dignity and confidentiality is respected including in the collection, use and disclosure of personal information.

3.3

Complaints and service user feedback

Complaints and service user feedback are dealt with fairly, promptly, confidentially and without retribution.

3.4

Advocacy

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.

3.5

Independence

The independence of service users is supported, fostered and encouraged.

Quality of Care Principles 1997

29 Sept 1997
(see Gazette 1997, No. S380)

Schedule 3 (items 1.1, 1.3, 2.1, 2.3, 3.1, 3.3): 1 Jan 1998
Remainder: 1 Oct 1997

Quality of Care Amendment Principles (No. 1) 1998

21 Aug 1998
(see Gazette 1998, No. S413)

21 Aug 1998

—

Quality of Care Amendment Principles 2003 (No. 1)

26 Nov 2003
(see Gazette 2003, No. GN47)

26 Nov 2003

—

Quality of Care Amendment Principles 2008 (No. 1)

18 Mar 2008 (see F2008L00834)

20 Mar 2008 (see s. 2)

—

Quality of Care Amendment Principles 2009 (No. 1)

16 Dec 2009 (see F2009L04649)

1 Jan 2010

—

Quality of Care Amendment Principles 2010 (No. 1)

23 June 2010 (see F2010L01651)

1 July 2010

—

Quality of Care Amendment Principles 2011 (No. 1)

16 Feb 2011 (see F2011L00266)

1 Mar 2011

—

Part 1

S. 18.3...................................

am. No. 1, 2008; No. 1, 2011

Note to s. 18.3......................

am. No. 1, 2003

Part 2

Heading to Part 2................

rs. No. 1, 2003

Division 2.1

Heading to Div. 2.1.............
of Part 2

ad. No. 1, 2003

Heading to s. 18.5...............

rs. No. 1, 2003

S. 18.5...................................

am. No. 1, 2003

S. 18.6...................................

am. No. 1, 1998; No. 1, 2008; No. 1, 2009

Division 2.2

Div. 2.2 of Part 2..................

ad. No. 1, 2003

S. 18.6A.................................

ad. No. 1, 2003

S. 18.6B.................................

ad. No. 1, 2003

rs. No. 1, 2010

Part 5

S. 18.14.................................

am. No. 1, 2011

Note to s. 18.14....................

rs. No. 1, 2011

Part 6

Part 6.....................................

ad. No. 1, 2011

S. 18.15.................................

ad. No. 1, 2011

S. 18.16.................................

ad. No. 1, 2011

Schedule 1

Schedule 1...........................

am. No. 1, 1998

Schedule 2

Schedule 2...........................

am. No. 1, 1998

Schedule 3

Schedule 3...........................

am. No. 1, 1998

Schedule 5

Schedule 5...........................

ad. No. 1, 2011