General Frequently Asked Questions
1. Where can I find more detailed information on the Home Care Standards?
Details on the Home Care Standards may be found at Home Care Standards webpage.
2. Which home care programs are the Home Care Standards applicable to?
The Home Care Standards are applicable to the Home and Community Care Program (HACC), Home Care Packages and the National Respite for Carers programs.
3. When did the Home Care Standards commence?
The Home Care Standards came into effect on 1 August 2013.
4. How many Standards and expected outcomes are there in the Home Care Standards?
There are three Standards: Effective Management, Appropriate Access and Service Delivery and Service User Rights and Responsibilities. There are 18 expected outcomes: eight management outcomes, five service delivery outcomes and five service user rights outcomes.
5. Do we still need to comply with State and Territory Government funding requirements and program guidelines?
Yes. Funding requirements and program guidelines/policies specific to the programs your organisation is funded for by State and Territory Governments still need to be complied with. Information on the resources that may be helpful is included in the Home Care Standards Guide.
6. What is the Quality Reporting Program?
The Quality Reporting Program is part of the Department of Social Services’ comprehensive quality aged care framework. It places a strong emphasis on promoting continuous improvement and requires providers of aged care services in the community to appraise their performance against the Home Care Standards (the Standards) and demonstrate the outcome during a quality review visit at least once during a three-year cycle.
Aged care services providing Home Care Packages Levels 1-4, the National Respite for Carers (NRCP) Programme and Commonwealth Home and Community Care (HACC) services are required to demonstrate and report on how their service meets the three Home Care Standards
The Quality Reporting Program is currently administered by the Department of Social Services. From 1 July 2014, the responsibility for undertaking quality reviews will be transferred to the new Australian Aged Care Quality Agency (the Quality Agency) which was established under the Australian Aged Care Quality Agency Act 2013.
The Quality Agency will administer the Quality Reporting Program in accordance with the requirements set out in the Quality Agency Principles 2013, whilst continuing to assess against the requirements of the Home Care Standards.
7. What is the streamlined approach to quality reviews?
From 1 January 2014, the Quality Reporting Program commenced a new streamlined approach to quality reviews that is consistent with other aged care regulatory programs. This streamlined approach provides efficiencies in the quality reporting process, particularly for those service providers that deliver both home and residential care across multiple outlets and service types.
The four key areas which have been streamlined are:
Self-Assessment Tool (SAT)
Providers are no longer required to submit the SAT before the site visit, although it must be presented to the quality review team for consideration at the site visit.
Providers can use a self-assessment tool of their choice. When deciding on a tool, the provider must ensure the self-assessment is conducted against the Home Care Standards.
Reviews across all service types
Reviews are conducted across all service types, rather than against each individual service type.
Providers will have two days following the exit interview to submit evidence if required.
Quality Review Report
The Outcome 1/2/3 scores have been removed from Quality Review Reports.
Providers are now given an interim Quality Review Report (QRR) for comment prior to the final decision being taken by the department’s decision maker.
A Timetable for Improvement has been introduced to provide a framework around identifying and rectifying Not Met findings, which is consistent with the process for residential aged care.
Annual Improvement Plan
Providers are no longer required to submit an Annual Improvement Plan. Instead, providers will be required to maintain and update a Plan for Continuous Improvement which can be requested at any time during the cycle.
7. How often are quality reviews conducted?
Quality reviews are usually conducted at least once in a three year cycle; however, if follow-ups are required as part of your quality review or on-site follow-up forms as part of your local jurisdiction’s process, you may have more than one visit in the three year cycle.
8. How do we know what information the quality reviewers will want to look at for each expected outcome?
Quality reviewers will look for evidence your organisation is meeting each expected outcome. The self-assessment tool may assist your organisation in identifying relevant evidence to demonstrate you are meeting the Standards.
9. Who will be conducting the quality reviews?
Quality reviews will be conducted by quality reviewers from the Department of Social Services.
From 1 July 2014, quality reviews will be undertaken by quality reviewers from the Australian Aged Care Quality Agency.
10. Who conducts the quality review if we are funded for both packaged care and HACC?
If your organisation is funded for both packaged care and HACC these will be, where possible, assessed together in a combined review with quality reviewers from each department/delegates. The government departments/delegates will coordinate and plan the visits and contact you about the requirements.
11. How many quality reviewers will review our service?
Generally two quality reviewers will review services. If your service is very small or very large this may be varied but the government departments/delegates will advise you when planning your visit. One of the quality reviewers will be designated as the Principal Quality Reviewer and will be your main point of contact during the review process.
12. Will the quality reviews be very different from previous reviews?
The process of the quality reviews (talking to staff from your organisation, reviewing policies and procedures and records) will be the same and will continue to be based on a continuous quality improvement approach. There may be some changes depending on your State/Territory and programs delivered, including:
Quality reviewers may work independently of each other and review different elements of your organisation so that all expected outcomes can be reviewed in the allocated timeframe. The quality reviewers will want to talk with some of your service delivery staff and your service users (and/or their representatives) either face-to-face or by telephone to determine that the services delivered are meeting service user needs. These interviews will be planned with you prior to your quality review visit.
You will be rated as having ‘met’ or ‘not met’ each expected outcome. If you are rated as ‘not met’ in an expected outcome, you will be required to identify improvement opportunities and include these in your Plan for Continuous Improvement and submit to the quality review team for consideration. In addition to the quality review process, your Plan for Continuous Improvement needs to be monitored, reviewed and updated regularly and submitted if requested to demonstrate ongoing continuous improvement.
13. What is included in the quality review process?
The quality review process is generally a 15 week process and includes:
notification of the quality review;
a self-assessment completed by the funded organisation using an assessment tool of your organisation’s preference;
an on-site visit;
provision of an Interim Quality Review report and a Final Quality Review Report;
a Timetable for Improvement if your organisation is assessed as not meeting one or more expected outcomes of the Standards; and
ongoing development of your plan for continuous improvement.
14. What is the purpose of the self-assessment?
The self-assessment provides an opportunity to service providers to review their organisation’s practices and identify areas for improvement. Quality reviewers use the self-assessment to:
gain an insight into the service provider’s operations;
understand the current practices and processes the service provider uses to meet the Home Care Standards;
review the information contained in the self-assessment to identify issues that need to be discussed during the on-site visit; and
assist in the planning of the on-site visit including organising interpreters and service user interviews.
15. What should be included in the self-assessment?
Service providers should consider the following for inclusion in the self-assessment tool:
information about the organisation, its service users, funding received, services provided and quality processes used;
practices and processes, results and plans for improvement against each expected outcome; and
the service provider’s assessment about whether the organisation has met or not met each expected outcome.
16. What results should our organisation provide in the self-assessment?
Results can be sourced from a range of activities that your organisation already completes. For example, survey results, feedback, compliments and complaints information, audit results, hours of service, staff retention rates, training record information, waitlist information, referrals etc.
A self-assessment should clearly demonstrate that your organisation is delivering services in accordance with the Home Care Standards.
17. How long are the site visits?
Site visits will usually be of one day duration. If your service is very small or very large this may be varied but the government departments/delegates will advise you when planning your visit.
18. How do I prepare for the on-site visit?
Preparing for the on-site visit includes:
liaising with the Principal Quality Reviewer of the Quality Review Team regarding the schedule of the visit;
advising staff and service users/representatives (who may wish to meet with the quality reviewers) of the quality review visit (and interpreters if required);
preparing records and documents to show the quality reviewers;
organising some staff and service users (and/or their representatives) to be available to talk with the quality reviewers; and
preparing an area for the quality reviewers to work from.
19. What is the format for the quality review visit?
An agenda for quality review visits typically includes:
an entry meeting;
documentation review and discussion with management personnel;
interviews with service users/representatives (or telephone interviews);
meeting with support staff and other personnel;
review of records and documents relevant to the Standards; and
an exit meeting.
Each service and organisation is different. The Quality Review Team will work with each organisation to plan the quality review including giving consideration to the service providers’ operations and service user group.
20. Why do the quality reviewers want to talk with staff/volunteers and service users and/or representatives?
Talking to a range of stakeholders provides the quality reviewers with the opportunity to validate information from other sources and to assess whether the services delivered are meeting service user needs.
21. How do we ensure that we have gained consent for the Quality Review Team to view service user and staff records?
The Quality Review Team will need to access a random selection of service user and staff records to validate that Expected Outcomes are being met. Organisations are required to ensure the privacy and confidentiality of this information. The Commonwealth and State and Territory governments have different arrangements for authorising access to records (including, for the Commonwealth, authorised officers under the Aged Care Act 1997, with specific powers in relation to Home Care packages).
For this reason, if your services are funded by both the Commonwealth Government (through Home Care packages and the NRCP) and State or Territory government (through the HACC program), it is advisable that you include access to records by quality reviewers in your generic consent forms for service users and staff. The principal quality reviewer will check that you have consent from your service users and staff to review records (where appropriate) when they contact you to plan the on-site visit.
The Quality Review Team members are bound to keep information they review confidential.
22. Will the quality reviewers talk to us during the visit about met or not met expected outcomes?
The quality reviewers will advise you if it appears that you have not met one or more expected outcomes. They will also explain the reasons why they will make this recommendation to the Delegate.
You will have two days after the review visit to forward any additional evidence for consideration by the quality review team before the Interim Quality Review Report is sent to you.
23. What happens once the quality review visit is over?
The quality reviewers will provide you with an Interim Quality Review Report outlining your performance against the Home Care Standards and each expected outcome.
If additional information is received within two days after the site visit, it will be considered and an interim decision made regarding the findings.
The interim QRR gives you an opportunity to consider the interim findings and allows 10 days to provide further information. If additional information is not received by the department within 10 days, the interim findings will be sustained.
If additional information is received, the evidence will be considered and a final decision made regarding the findings. The outcome of the decision will be reflected in the Final Quality Review Report with each met or not met finding being supported by an evidenced based Statement of Reasons.
24. What is in the quality review report?
Both the interim and final quality review reports contain the following information:
the findings of the of site visit against the Expected Outcomes;
an audit trail of who was interviewed during the site visit and the evidence reviewed; records the on-site assessment for the funding body.
a Statement of Reasons and a Met/Not Met finding for each expected outcome ; and
a detailed reason for all not met expected outcomes, including details of the evidence that led to the finding. If you receive one or more Not Met expected outcomes, you should use the final quality review report to assist you review your Plan for Continuous Improvement and to identify improvement activities.
25. What is the purpose of the Plan for Continuous Improvement?
Throughout the three-year cycle, you are required to develop, monitor and review strategies and treatments to support continuous improvement in the delivery of aged care in the community. It should be reviewed regularly to ensure currency and amended where necessary throughout the review cycle.
At any time during the three-year cycle, you may be asked to provide a copy of your Plan for Continuous Improvement.
25. Why do I have to review my Plan for Continuous Improvement as part of the quality review process?
If you receive one or more Not Met findings, you will be required to revise your Plan for Continuous Improvement and detail the actions to be undertaken in order to rectify the expected outcomes that have not been met.
When you receive your Final Quality Review Report, you will have 10 working days to identify the appropriate actions for all the expected outcomes that were assessed as Not Met and return your Plan for Continuous Improvement to the quality review team for approval.
The quality review team will assess whether the proposed action is sufficient to address the expected outcome that was not met and if sufficient, you will be advised in writing. This is when the 12-week Timetable for Improvement commences.
In some instances, the identified remedy may not require the full 12-week period. In these circumstances, you should advise the quality review team of the reduced time period for remedy.
26. What is a Timetable for Improvement?
A Timetable for Improvement is a framework to assist you to remedy issues identified in the Final Quality Review Report in a timely manner. It provides a time frame for action, generally 12 weeks. It is during this time that the activities identified in your Plan for Continuous Improvement should be implemented.
27. What if our organisation has a complaint about the quality review process?
You can make a complaint about any aspect of the quality review process at any stage. To do this, write to the supervisory jurisdictional manager of the quality review program within the relevant State or Territory office, who will look into your concerns.
28. Are quality reviewers qualified to conduct reviews?
Quality reviewers are experienced in conducting quality reviews and have appropriate experience in the aged care in the community sector. Quality reviewers have received specific training in the quality review process and Home Care Standards.
29. Who makes up the quality reviewer team?
The quality review team is generally made up of a Principal Quality Reviewer and a Quality Reviewer who work together to conduct the quality review. If a joint quality review is being conducted, a representative from each government department/delegate will make up the team. The name and contact details of the Principal Quality Reviewer will be provided to you when you are notified of the quality review visit as this is the person you will liaise with regarding your visit.
(Home Care Standards Guide Appendix 1 / Section 2.4.1 / p 7)
30. How applicable are the Home Care Standards to National Respite for Carers (NRCP) funded services?
The Home Care Standards apply to NRCP funded service delivery. The expected outcomes relating to management apply to all organisations in the context of their individual arrangements. The service delivery and service user rights and responsibilities expected outcomes are applicable to all service users, including carers.
31. Why are Expected Outcomes only rated as ‘met’ or ‘not met’?
The aim of the Home Care Standards is to provide a range of minimum standards that guide the delivery of high quality community care. Rating the Expected Outcomes as ‘met’ or ‘not met’ provides clarity for funding bodies and service providers about specific areas which require further improvements. The current framework does not provide a ‘partly met’ or ‘working towards’ rating.
If an Expected Outcome is rated as ‘met’, an organisation may still identify improvement opportunities within its ongoing Plan for Continuous Improvement although it is not a requirement of the quality review process.
If an Expected Outcome is rated as ‘not met’, an organisation will be required revise its Plan for Continuous Improvement to identify and detail clear actions (and timeframes) that are necessary to meet the Expected Outcome. The Plan for Continuous Improvement must be approved by the quality review team before the Timetable for Improvement commences.
(Home Care Standards Guide 2.4.4 / p 15)
32. Will my ongoing funding be affected if our service is rated as ‘not met’ in some Expected Outcomes?
Funding for service providers will not be directly affected by the quality review process itself. The Home Care Standards utilise a continuous quality improvement approach to resolving issues of concern identified through quality reviews. In the main, service providers are required to submit its Plan for Continuous Improvement to the quality review team setting out how improvements activities will be implemented. However, where there are significant concerns necessitating referral for compliance and program management action, subsequent measures may have an effect on the ongoing funding of the service provider.
33. Is information regarding the outcome of quality review visits shared with funding managers or other government departments?
Information from the quality reporting process may be shared with other areas of the department for a variety of reasons. Under the Home Care Standards framework, information may be shared between the Commonwealth and State and Territory governments during the planning and undertaking of a joint review. This would be done in consultation with the service provider.
Additionally, where joint reviews of service providers receiving both Commonwealth-only and HACC program funding are not possible, information prepared by service providers for quality reviews can be shared between the Commonwealth and State and Territory governments with the agreement of the service provider under review.
34. Is information regarding each organisation’s quality review visit outcome made publicly available?
Aggregated information is published but information in relation to individual organisations is not made public at present. However, it is possible information of this nature may be requested through the Freedom of Information legislation.
35. If we address all of our ‘not met’ outcomes in the required time frames are our ratings then changed to ‘met’ on the records?
No, the records will show that you have taken appropriate action to address the not met outcomes in the required time frame. At the next quality review you will be assessed against the expected outcomes again.
36. Will a nurse or health professional be assessing the delivery of nursing services or high care service delivery?
Some jurisdictions have nurses and health professionals in the Quality Review Team and all jurisdictions provide the Quality Review Team access to advice from nurses or allied health professionals if a technical care issue requires discussion during a quality review.
37. What is our responsibility in meeting the Home Care Standards when we sub-contract some or all of our services?
As the organisation which receives funding to deliver services you are responsible for ensuring that those services meet the requirements of the Home Care Standards, even if you are not directly delivering services. Organisations use a range of mechanisms for ensuring that requirements are met by the organisation delivering services including: developing sub-contracting agreements; conducting meetings and communication strategies; instituting structured ongoing monitoring processes; being notified of service user feedback and complaints; and third party reviews.
Third party reviews can involve the funded organisation going to the organisation that is responsible for service delivery and reviewing their operations and records to determine that services are being delivered as required.
If you sub-contract services, the quality reviewers will be interested in understanding what practices and processes you have in place to ensure that the sub-contracted services are meeting service user needs and the requirements of the Home Care Standards.
38. If we receive both HACC and packaged care funding, will we always have a joint quality review visit?
Joint quality reviews are planned for organisations that receive both HACC and packaged care funding; however, due to local jurisdictional arrangements, this may not always be possible. The arrangements for joint quality review visits will be discussed with you when your quality review is due.
39. Are the Home Care Standards appropriate to counselling services?
Yes. The Home Care Standards are appropriate to counselling services as the service delivery Expected Outcomes are based on ensuring access, assessment, care/service plan development, reassessment and referral, if required. Counselling services may use other terminology for their care/service plan, but they do develop a plan of care/support for each service user based on the service user’s needs. Counselling services are required to have in place appropriate management practices and support service user rights in the delivery of their services.
40. Are the Home Care Standards appropriate to organisations providing services to people with special needs including Aboriginal and Torres Strait Islander people and, people from culturally and linguistically diverse backgrounds?
Yes. The Home Care Standards are appropriate to organisations that provide services to Aboriginal and Torres Strait Islander people and people from culturally and linguistically diverse backgrounds. The ‘practices and processes’ section of each of the service delivery and service user rights and responsibilities Expected Outcomes make reference to meeting the needs of people with special needs.
As with all organisations delivering community care services, organisations who provide services to people with special needs are required to have in place appropriate management practices to support the delivery of their services.
41. What is a ‘service outlet’ and how will quality reviews be conducted when an organisation has multiple service outlets within a region?
A service outlet is defined as ‘the base from which services are coordinated, and where hard copies of service users’ files are located. A service provider may have several outlets or just one.’
Service providers delivering Commonwealth funded services (Home Care packages and NRCP) will undertake a quality review at each service outlet.
Arrangements for HACC services vary between jurisdictions. Services will be advised of how the quality review will be conducted at the time it commences.
44. How do the Home Care Standards apply to services funded under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program?
Where an Aboriginal and Torres Strait Islander Flexible Aged Care service is funded separately to provide HACC Services, the service provider will also participate in reviews under the Home Care Standards and may report on some of the same information required under this Quality Framework (or vice versa).
In this event, the quality reviewers and the service provider will liaise to identify any relevant information common to both processes that can potentially be shared between reviewers, to avoid a duplication of effort. It will however, be important for the quality reviewers to determine that the information is current and relevant to the expected outcome of the particular standard.
This will need to be on a case-by-case basis in consultation with the service provider and the relevant areas of the department.