March 2017 - Network Meeting Minutes

ACQA NETWORK MEETING MINUTES
3rd March 2017
Gumercha Hospital

Present:

  1. Sue Ferrris Riverland Murray Coorong,
  2. Gail Harding Wheatfields Inc,
  3. Melanie Milne Wheatfields Inc.,
  4. Bronwyn Antwis Riverton,
  5. Pauline Oates Hawker,  
  6. Bridget and Jenny Long Jallarah Homes,
  7. Tania Woolford, Mt View Homes,
  8. Dawn Hilditch, Maggie Hayward, Yvonne Pengilly, Dianne Adams,  Hamley Bridge,
  9. Cindy Gumeracha and Mt Pleasant Hospitals.

Apologies:

  1. Lesley Hawker West Wimmera Health Service,
  2. Matt Kowald Barossa Village,
  3. Jenny Fairy Barossa Village.

Gail Harding welcomed all attendees.

 

It was announced that if you are attending at Gumeracha please do not to come through the Hospital anymore, to come straight around the back of hospital to the day centre. There is no need to sign in as it is not considered part of hospital operations.

Discussion on Accreditation Visits

Spot visits –

Wheatfields had an unannounced visit and medication management was assessed.

Medication times on Lee Care were entered as the exact time medications were given because it is a computerised system. The assessors questioned that there was discrepancies in the time drugs were actually given, eg if it said 0800, drugs were actually given at 0810 and therefore were late. It was suggested that if this occurs staff indicate that this is the 0800 drug round and inform the assessors that there is a parameter for drugs to be given. This may need to be a policy.

BoolerooCentre: 2 days re-accreditation:  Issues pain medications not being followed up within an appropriate time. As experienced care staff give medications they also had to look at what pain is exactly for (eg, Endone - sever pain in either knee, hip, shoulder on medication charts) if not listed need to contact RN. Needing to change procedures to match this recommended in regards to pain management.

Hamley Bridge due in June for 3 day accreditation.

Country Health (Cindy )–Gumeracha and Mt.Pleasant:  Looked at Information management/ continuous Improvement/ complaints, Nil issues. They were overall happy with the process.

Renmark spot visit–Sue was not able to be there but they looked at - Human resources (unsure what they looked at into this)

General discussion on what’s happening at facilities;

Wheatfields is looking at restructuring with the funding cuts, due to no CPI Increase for 2 years. (Approx $70,000 in reductions as announced by the Commonwealth). (Casuals versus Permanent,) if you’re working regular shifts on particular days you have to be permanent. Wheatfields roster all permanent shifts with permanent part time or full time staff.  If a person goes on leave (eg parental, sick leave or annual leave or Return to Work) casual staff will get a temporary contract for that time that staff member is on leave for.  It used to be that there was not a huge difference between paying casual as opposed to permanent staff however now that casuals get 25% loading and the 9.5% for super, facilities cannot afford to employ staff casually unless for temporary periods. All regular shifts must be on a PPT contract.

IMPROVEMENTS –

Hamley Bridge – front door policy transferring residents that have passed lining corridor with staff and residents with music playing and everyone had a flower, staff residents place flowers on barouche as it moved through the corridor , family member placed flower on barouche last. Permission received from family prior to attending to this and assisted with the organising of picking of flowers to be placed on the body so they feel involved.  (Dove call) the flow through facility is a lovely feeling and it gives the chance for staff and residents to say goodbye and have closure. Admitted through the front door leave through the front door just seems fair that the come in through front door and they leave the same way. Very positive feedback from the first time they tried.

Annual memorial for all deceased residents, as well as the one after the death for each care recipient.

Cindy - Country Health (Gumeracha) – organising an evening ball with a dance group and dress up in evening wear. Everyone is excited to see how this will go. Residents are excited and so are staff. Trading table for the month of December staff invited to bring in things to donate, residents family members made cakes and biscuits – made around $100 a day, funding to go towards leisure activities for Care recipients.

Music therapy for behaviour management – IPods with Care recipients favourite (individualised) so they can put headphones on and spend time listening to music.

BoolerooCentre:  - Beer O’Clock 4pm on a Friday for 1/2hr– Open to community, a mural has been painted on the wall, and they are adding specifics related to Booleroo. They are getting a bar on wheels to place in a corner that they can roll out for Beer O’clock. They have purchased some schooners, wine glasses and slowly getting more items to make it feel more like a bar set up. There has been a positive response from residents and the wider community with this initiative.

Wheatfields Inc. Murals on door in Dementia area, which was a great success and Care Recipients and families enjoy looking at the lovely designs, and has reduced care recipients walking into other care recipients rooms.

Hawker Concerns: Country Health does not have access to leisure and lifestyle activities regularly possibly only 2-3 days a week in residential aged care. They feel that this needs to be extended.

 

CLINICAL INCIDENTS – REVIEW

  1. Form date – is the month due as shown on the audit timetable. This will be the date that your statistics will be benchmarked against.
  2. Drop down box at the top needed for free text on the system as it applies to each facility.
  3. Must be able to print complete Audit with all information showing. There is a problem at the moment that the drop down boxes do not print off, when printing. This needs to be fixed.
  4. Drop down box for each question to be able to add information that refers to that question.
  5. Remove N/A options for questions 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.8, 3.9, 3.10, 3.11, 3.14, 3.15
  6. Remove the words ‘by management’ in question 3.6.
  7. Definitely Drop down box for question 6.
  8. Cat Carroll – discuss the format of reporting an incident and documentation in residents file (complete out incident form on Lee Care and completing SLS re-Country Health) Attendees felt that it was necessary to complete the incident form on Lee Care and send to progress notes as this was a complete picture of the incident that needed to be reported in the case notes, AS WELL AS completing the information in SLS. ACQA may be able to inform Cat Carroll of this.
  9. (Last May went through some Aduits and lots of changes where to be made but have not been upgraded on the system (leisure and lifestyle, assessment and care planning) will need to look at May minutes. These need to be reviewed and acted upon.
  10. Adding a section to Audit to show that we have reviewed all systems in regards to this particular area (e.g policies/ procedures)  This should be added at the beginning of each audit.
  11. Unwitnessed falls or witnessed and head injuries observed  for residents on Warfarin, need to be sent to have a CAT Scan completed. Some facilities may send to Hospital for hospital staff to assess to see if they need a cat scan. This has been the recommendation from the coroner
  12. Free text – need to be allowed to extend boxes. When print completed copy it’s not printing all information, only first few lines of information. This is very important for accreditation and for RCF follow up.
  13. Discussion re- Drs being able to refer Care Recipients via “anywherehealthcare” to arrange other appropriate health professionals.
  14. Need to be able to modify the Continuous Improvement Plan, information from Audits it transferred to CPI section on ACQA once audit approved you are not able to make changes to the CIP.
  15. Checking of Incident forms:

INFECTION CONTROL

  1. Check references to ensure links work.
  2. Q.3 – in addition to the infection reporting (make easier to understand)
  3. Add ‘Other box’ for Q.4.  add drop down box for all ‘other’ options to add information
  4. Q.10 – Add ‘other’ box – click yes on Q.9 for Q.10 to show. add drop down box for all ‘other’ options to add information
  5. Q. 13 – add IM to IV section as an option
  6. Remove Q.15 as Q14/Q15 very similar

SKIN INTEGRITY

  1. Check resources to ensure all links are accurate
  2. Q.2 – currently NA to aged care to add an N/A option
  3. Q.4 - Add ‘other’ box - add drop down box for all ‘other’ options to add information
  4. Q.8 – add drop down box for all ‘other’ options to add information
  5. Q.9 Remove Medical officer appointment and …. (2 options)
  6. Q.11 information on classification for what each level is
  7. Q.12 expandable box

BEHAVIOURS OF CONCERN (spell correctly/ Australian spelling)

  1. Top section - 3. WH&S not occupational
  2. Check resources 3&4
  3. Q5 Type of service need to be consistence through-out the board.
  4. Q.8 Add ‘other’ box with drop down box to add information.
  5. Q.10 Add option (boxes) ‘new care recipient’ / and ‘sporadic’
  6. Q.20Add ‘other’ box with drop down box to add information.
  7. Q.21 Add ‘other’ box with drop down box to add information.
  8. Q.22 remove ‘Dementia’ only have secure unit.
  9. Q.23 – definitions

FALLS

  1. Check and remove none relevant info on top of form - eg best practice.  
  2.  Q.8 Add ‘other’ box with drop down box to add information.
  3. Q.9 – change question to ‘was this incident a witnessed or unwitnessed fall?
  4. Q.11 change heading to fracture, drop down box location of fracture. Add ‘other’ box with drop down box to add information.
  5. Q.12 Add ‘other’ box with drop down box to add information.
  6. Q.14 If yes option to Add Hazard ID no.
  7. Q.15 (4. – remove different types, have only 4 more medications) completely remove (5) is the care recipient taking 12 doses of medications a day. Place ‘none of the above down the bottom.
  8. Q.16 change q to was a restraint used. If yes then choose. change tub chairs to princesses chairs / move none to the bottom
  9. Q.20. Drop down box if yes to Add information Drs information time / date contacted.

MEDICATION

  1. Check all information relevant at top section of form
  2. Check/ update all resources.
  3. Q5. Have the same as other incident forms
  4. Q.9 Add ‘other’ box with drop down box to add information.
  5. Q.10 Add unknown
  6. Q.12. change Q description of the incident
  7. Add another question: immediate action taken
  8. Q.14 Definitions

WH&S

  1. Check top information up-to-date and correct and links are active
  2. Q7. Put the other box at the bottom with a drop down box to add information.
  3. Q.11 if yes drop down box reported to who and when
  4. Q12, check and update - INCIDENT NOTIFICATION FACT SHEET

ALL INCIDENTS FORMS

  1. Add classification - high/ medium/ low/ Nil to all incident’s forms
  2. Make sure all forms have Care Recipients ID only ‘no other option’.

 

MEDICATION CHART AUDIT REVIEW– check May 2016 minutes

  1. 3. National inpatient medication chart user guide change and update information
  2. 4. guiding principles to medication management in Aged CARE Facilities has a new edition.
  3. Make sure all links go to the correct places
  4. Remove N/A from Qs: 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 3.10, 3.11, 3.12, 3.13, 3.15, 3.16, 3.17, 3.18, 3.19, 3.20, 3.21, 3.22, 3.23.

ASSESSMENT AND CARE PLAN AUDIT

  1. Check and update any info in top section + references
  2. Remove N/A from Qs: 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, 4.10, 4.11, 4.12, 4.13, 5.1, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 5.10, 5.11, 5.12, 5.13, 5.14, 5.15, 5.16, 7.1, 7.2, 7.3, 7.4, 9.1, 9.2, 9.3, 9.5, 11.1, 11.2, 11.3
  3. Updates to Qs: Q5.15 – current RECOGNISABLE photo
  4. For all forms add the save section to the top and the bottom of the forms. Make all boxes expandable

NOTE FOR ALL PRACTITIONERS

Panadol Osteo – doesn’t break down and becomes Panadol toxic in the body. Review usage for residents with compromised liver function.

If there something new in relation to Audits that anyone would like to add Please let Gail know at don@wheatfields.net.au

INFECTION CONTROL

  1. Additional Audit required to be completed Annually to look at overall Infection Control Practices. Gail to look at and either make available for all facilities to complete annually independently or to add to audit schedule on ACQA.
  2. Change Hand Hygiene audit to 2x yearly. – need to look at legislation into having to have small/medium/large gloves available in all areas. All questions are in place to cover the legislation.

PLATFORM ISSUES:

  1. Since new platform anyone having any problems still? No issues from anyone at present.
  2. Not able to print and download CI plan/ complaints/ compliments properly. Will need to see if this can be changed/updated to improve this. There has been some concern that these are not easily available. Gail to discuss with Steve to see how this can be resolved. Matt has discussed this and highlighted this and it may already be getting looked at.
  3. CONCERN: When you have more than one site linked to ACQA you want a total amount of incidents in overall areas, you have to do a manual count for each individual areas to get an overall total.
  4. On time table – Audit statussome state Not started/ not completed. When roll over some of the site some of the information has not been transferred over.
  5. Audit dates – showing up over due at beginning of month when its not due until the 15th of the month.
  6. Compliments and Complaints: Showing on the main screen Compliments/ Complaints/ improvements that many reports as drafts/ waiting for approval but when go into each form there are none of these to be approved.
  7. Access: Need access to each individual region ‘not all areas in ‘country health’ some area cannot see there region. This may be a permissions problem. Discuss with Steven to see if this can be remedied.
  8. RESULTS: Group and country health are same percentage when shouldn’t be. To be looked at to see where the problem lies.
  9. RIVERLAND ISSUES: 2 sites and 1 audit as names changed when new system put into place sections of program (eg audits) have not been migrated over to new system. ‘Country Health’ – Riverland
  10. Settings - add users / delete/ edit – still need to be able to delete and add a new person with the same email address as the previous person. 
  11. Paper usage for printing; Over use of paper when printing the Audits and each section on new page (eg section 2 has one question and takes up the whole page.)
  12. Graphing: Accessing forms from dashboard the information is not true and correct, not coming across to graphs as correct information. (e.g fall/ medications)
  13. Need for further information: Not easy to understand, need better instructions for what things are for through website. (e.g – incident summary symbols on the same line, would like to be able to wave mouse over to say what the symbols are for)
  14. Audit overview :– would like to be able to see all areas in particular regions on same graph.
  15. Re - Audits look at summary and go into actions and they are not all there.

More feedback to access via website.

Improvements – Hamley Bridge – mobile to alert staff of available shifts then is up to the staff to pick up shifts, working really well. Wheatfields have done this as well and find it successful as well. Saves on staff time to organise shifts,

Consumer directed care – This is about what we as consumers want in consumer directed care. Individuals don’t get the money, still goes to company who is offering home care. Individual care needs will be charged at a particular rate.  They will also be looking at similar ways in aged care facility. Individuals have more of a say in what their care needs will be.

Accreditation agencies moving towards looking that care recipient’s quality of life and how happy they are. Now using tablets to document straight away and to give direct feedback so that it ois transparent.

For Follow Up

Gail will check with Steven Charman  in 4 weeks if haven’t heard any feedback from today’s meetings and the changes recommended.

Reminder to all Managers that there is a place to report ‘Unlicensed health practitioners’ who have been suspected of resident abuse.

 

Meeting closed at 4.00pm with Gail Thanking all those for their attendance and a reminder that if facilities needed some support, please contact either Gail or Matt and although thy may not have the answer they will try to put you in touch with someone that can assist.