Minutes of Network Meeting

Senior Citizens Friendship Hall Nuriootpa

28 May 2015 9.30 – 3.30

Present

Matt Kowald, Barossa Village
Dawn Hilditch, Hamley Bridge
Bridgette Van den Brink, Jallarah Homes, Meningie
Gail Harding, Wheatfields
Maggie Hayward, Hamley Bridge Memorial Hospital
Ronnie Leng, Jallarah Homes, Meningie
Aileen Robertson, ACQA Board Member
Cindy Waples, CHSA – Mt Pleasant/Gumeracha
Barbara Nutt, Orroroo Community Home
Marlene Durdin, Wheatfields
Merrilyn Good, Care Manager, Barossa Village
Yvonne Dengilly, Hamley Bridge
Jenny Fairey, Quality Coordinator, Barossa Village

Apologies

Barbara Whelan, Abbeyfield
Bernie
Desiree May, CHSA
Sue Ferris Aged Care CHSA Mannum
Bev Galway, Tununda Lutheran Homes

ITEM 1 – Q&A

1.1 ACQA program user levels

The general user can ent4er information straight on system, fill in the forms and save the forms.

Quality managers have all the general user access and can see filled in forms, vet them and approve them.

Site managers/company managers can look at all sites in their organisation and monitor compliance.

In the next 3-6 months ACQA will automate password resets, in the meantime the new system is in place support@active.com.au. The staff at Intelligent Development are handling the set up of new passwords, adding and deleting users etc.

1.2 System updates from Pt Augusta Meeting

The leisure and lifestyle audit was reviewed at the Pt Augusta meeting and will be emailed to members to view prior to logging it for the next system upgrade. In future, system upgrades will be done on a bi-annual basis.

1.3 Links on audits

Some don’t work for a range of reasons but these are being logged and will be fixed. The members of the ACQA Board have access to the website and will inform members of changes to the ACQA website via the Active QMS dashboard.

ITEM 2 – NATIONAL AGED CARE QUALITY INDICATOR PROGRAMME

Federal Govt has engaged KPMG the conduct the National Aged Care Quality Indicator Programme. Sites were invited to participate in the project. ACQA will assist members to comply and report against the indicators. The data collected will be published on the My Aged Care website so consumers and families can review and compare sites.

The Programme and the data it collects will ultimately inform consumers and their families especially once consumer directed care rolls out in 2017.

The handbook that Gail Harding circulated contains standardised definitions that ACQA recommends our members use.

If members want to participate in the Programme, Matt encourages you to contact KPMG as he is confident that they will welcome more participants. The link to the website will be put on the ACQA website.

Matt made particular mention of the Quality of Life measure and he’ll keep members advised of developments in this tool.

ITEM 3 – GENERAL FEEDBACK

3.1 Matt Kowald – Barossa Village

Matt talked about developments at Barossa village. Increasing bed numbers, developing new initiatives for memory support, looking at food management systems particularly the use of food moulds, texture and quality of food and drink and the introduction of a language and cultural development program for German aged care residents.

3.2 – Mt Pleasant

Mt Pleasant actively seeking funds to build a safe outside area for memory support program.

3.3 – Staff Training

Discussion about mandatory training – varies between sites. Members shared their difficulty in getting care staff to take up the training programs that are offered in spite of incentives, paid time and flexible learning options. Some sites have redefined non-mandatory training topics to mandatory to increase staff take up of training offered. Barossa Village recommended some particular trainers and training organisations – contact Matt or go to their website for details.

First Aid Certificates became a topic for discussion – sites have different approaches to care workers having current first aid certificates. Common agreement is that first aid is important and sites should require staff to have a certificate and to support staff in maintaining their skills and certificates.

Qualifications of kitchen staff was raised and discussed – training options for staff include hospitality, health services, safe food handling and hand hygiene. There is a hand hygiene standard in Lee Care for those who have it.

ITEM 4 – MEDICATION CHART AUDIT TOOL

Matt referred to the National Quality and Safety Institute – National Residential Medication Chart (NRMC3) document – if you want a user guide for pharmacists that Gail Harding referred to please contact her directly. Gail is ascertaining if Lee Care is fully compliant. Email from ACS came out on the 20th of May about the changes – ACQA will post a link to this.

4.1 Add to rationale – “this audit applies to manual and electronic medication chart documentation”

4.2 Proposed changes to criterion:

In place of “medical officer” use “authorised prescribers” where it occurs
Change all spelling where “z” is used to “s”
Add “preferred name” to all medication charts
Include “recognisable” photo (item 4)
Record of known allergies “and sensitivities” (item 6)
Add question after item 7 “if no adverse drug reaction/sensitivity is recorded does the chart reflect “Nil known” (new number 8)
Take out “medication dose” (item 15)
Delete “ceased or” twice (item 17)
Change to “Do all medication charts include an administration record and have all administered medications been signed for” (item 19)
Gail will follow up with APRA to determine if there is a legislative or a benchmark for Doctor Reviews of medication charts (items 22 and 23)
“has any medication been prescribed by nursing staff” (item 25)

ITEM 5 – EMAILS FROM USERS ABOUT SYSTEM GLITCHES

5.1 links are broken – this will be addressed in next upgrade

5.2 on pages of drop down menus the “back to list” goes back to the current month but it would be preferable if it took the user back to the month they were looking at – the user has to keep resetting the parameters

5.3 problem with “assessment and care planning” audit questions 5, 7 and 9 that provide more drop down boxes if you answer “Yes” – they don’t print out in full if you want to complete the audit paper based

5.4 free text boxes meed to be able to expand or be expanded so you can see all that you’ve written not just a little box

5.5 may need to review the appropriateness of offering the “not applicable” option for a few more questions

5.6 skin integrity incident form – dropdown “nature of skin problem” – review the KPMG definitions for pressure injuries when they are done for this area and adopt those definitions

5.7 columns missing when pulling up report chart or information for printing (e.g. medication chart

5.8 when you’re in a document that has more than 2 pages is it possible for there to be “return to page #” instead of going back one page at a time

5.9 in any of the audits the boxes under “actions taken” should inform and populate a list of actions on improvement register – could it be set up where it says “do you want to create an action” and then this takes you to a list and it automatically populates a column with the audit details. Match the wording “action taken” – it is then contradicted by “actions required” – “actions required” would then go on an improvement register whereas “actions taken” don’t

ITEM 6 – CLINICAL INCIDENT AUDIT

6.1 tools – link to guidelines for completing audit tool disabled

6.2 performance measure of “reduction in incidents” is inadequate, consider instead “reduction of the risk associated with the incident”

6.3 need frequency of audit to be quarterly

6.4 review sample size

6.5 documents to be reviewed – include “and procedures” after policies and add “meeting minutes” at end of the sentence

6.6 Proposed changes to Criterion:

include “orientation and ongoing” staff development (item 5)
include “staff member’s name” before signature (item, 7)
delete item 12
drop down doesn’t work when you go to print off page – questions 1,2,4 in falls section don’t show
falls only section – question 5 replace with: “is the fall risk assessment appropriate”
falls incidents – question 2 have environmental risk assessment… needs a N/A
have there been any organisational improvements implemented to reduce the risk of ongoing incidents question
numbering is an issue throughout this audit tool

ITEM 7 – JBI SYMPOSIUM IN SINGAPORE – GAIL HARDING

This was a really significant experience as it reinforced for Gail the hours and hours that goes into the research and development of the evidence based practice standards. Gail reported that she felt heartened by the work and dedication that is applied to aged care nursing. Gail came away from the symposium believing that Australia has higher standards than most other countries and that our focus on resident care and outcomes is actually quite unique. It is apparent that Australia is a leader and JBI is the obvious leader in the industry and we should be proud that its based in Adelaide and of ACQA’s association with it.

JBI subscription deal done where a special rate was negotiated for CHSA. Now JBI are looking at a ‘fee per site’ payment structure. Updates and downloads can be easily done straight from JBI website and create your own manual. Alternatively you can purchase a full hard copy from JBI.

Meeting closed – Matt thanked all those who attended for their contributions to the development of ACQA audit tools.

Next meeting – Gumeracha