• Quality Care Advisory Body: Will the requirements apply to our service?

  From 1 December 2023, approved providers except those that are state or territory authorities, or are a local government authority, must comply with the requirement to establish and maintain a QC Advisory Body.^[1] This includes approved providers of the following services:
  

  • Residential Aged Care;
  • Short-Term Restorative Care at home and in Residential Aged Care settings;
  • Home Care Packages;
  • Multi-Purpose Services Program;
  • Transition Care Program.

  These requirements will not apply to services which operate under a grant agreement such as:

  • the Commonwealth Home Support Programme (CHSP); and
  • National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP).

  The providers of these services are not ‘approved providers’ under the Commission Act and the responsibilities (including the advisory body requirements) under the Aged Care Act apply only to approved providers.

  The key takeaway is that most approved providers will be required to have a QC Advisory Body in place from 1 December 2023.

• What is a QC Advisory Body and what is its purpose?

  The Royal Commission into Aged Care Quality and Safety found that improvements need to be made to strengthen approved provider governance arrangements.^[2]

  An important reform introduced by Parliament to address this is the requirement for providers to establish and maintain a QC Advisory Body.

  The purpose of a QC Advisory Body is to be an advisory body to provide independent feedback to the governing body of an approved provider on the quality of care provided to consumers. This is a role that is distinct from the role of the governing body (such as a board of directors).

  A QC Advisory Body must:

  • comply with the membership requirements set out in the Accountability Principles 2014 (Accountability Principles);^[3]
  • provide the governing body of the approved provider a written report about the quality of care at the aged care service, at least once every 6 months;^[4]
  • be able to, at any time, give feedback to the governing body about the quality of the aged care provided.^[5]

  The governing body of an approved provider must:

  • consider any reports or any feedback provided by the QC Advisory Body when making decisions in relation to the quality of the aged care provided through its services; and
  • advise the QC Advisory Body, in writing, as to how the governing body considered the report or feedback it provided.^[6]
• Are there membership requirements for a QC Advisory Body?

  In order for a QC Advisory Body to comply with the Accountability Principles, it must meet the minimum membership criteria and comprise at least 3 of the following members:

  1. a person who is key personnel of the approved provider and who has appropriate experience in the provision of aged care; ^[7]
  2. a person who is directly involved in the delivery of aged care or if the approved provider delivers clinical care – a person who is directly involved in the provision of clinical care; and
  3. a person who represents the interests of care recipients, for example:

  • a care recipient; or
  • a member of a consumer advisory body (if established);
  • a member of an organised consumer advisory service; or
  • a consumer advocate.^[8]

  A QC Advisory Body can include other members, but the minimum membership criteria must still be met. Approved providers should also consider including other persons with an interest in the quality of aged care delivered (Additional Members) and form a QC Advisory Body which is appropriate to the size of the organisation.

  Practical tips and things to consider

  • Consider if you have any existing committees or groups which can fulfil the functions and requirements of a QC Advisory Body (with necessary amendments to its charter or terms of reference).
  • Identify any individuals who may provide valuable supplementary feedback to your organisation’s governing body for inclusion as a member of the QC Advisory Body.
  • Consider any conflicts of interest and how these should be declared and managed. There may be factors which could influence feedback which will need to be taken into account when establishing a QC Advisory Body. Personal interests, conflicts or direct benefits to certain individuals are factors which may impact feedback provided. For example:
    • an employee or contractor providing clinical care to the approved provider’s consumers may have a conflict of interest for personal reasons (e.g. loyalty to colleagues or a family member who receives care from the approved provider);
    • representatives of the governing body are not recommended to be members of a QC Advisory Body, because the QC Advisory Body reports to the governing body. It is recommended that Additional Members be people who are not already part of the governing body.

  • The QC Advisory Body must operate in an independent advisory capacity. As such, approved providers may consider whether the QC Advisory Body members will receive any payment or reimbursement for any expenses.

  
  

• How should the QC Advisory Body operate?

  The legislation does not specify how each QC Advisory Body should operate. Each approved provider is required to consider the best way to comply with the requirements, taking into account matters such as:

  • the role and responsibilities of the QC Advisory Body as an advisory body as distinct from the role of the governing body of the organisation;
  • how the QC Advisory Body responsibilities will be incorporated into existing governance arrangements;
  • how the QC Advisory Body will be established, managed and reviewed;
  • how to maintain confidentiality of information shared with the QC Advisory Body; and
  • how to best support the QC Advisory Body (e.g. administrative support and provision of information).

  To ensure that the roles and responsibilities of the QC Advisory Body are clear, we recommend putting in place a written charter or terms of reference for the Advisory Body.

  One of the primary functions of the QC Advisory Body is to provide a written report to the organisation’s governing body about the quality of care provided at least once every 6 months. The reports must address the quality of care provided at each of the approved provider’s services and must be consistent with requirements of the Accountability Principles.^[9]

  The report must include any concerns that the QC Advisory Body has about the quality of care provided (for each service) during the reporting period and any updates about quality over time.

  The Accountability Principles provide a list of matters which a QC Advisory Body must take into account to comply with its reporting requirements under the Aged Care Act, including (but not limited to):
  

  • feedback from staff, care recipients and their representatives about the quality of care;
  • complaints and management of complaints;
  • regulatory actions taken by the Aged Care Quality and Safety Commission (ACQSC);
  • progress made in relation to any plans for continuous improvement (within the meaning of the Aged Care Quality and Safety Commission Rules 2018);
  • performance reports from the ACQSC;
  • staffing arrangements (e.g. availabilities of health practitioners or other health support, staff turnover, scheduling);
  • reportable incidents and actions taken by the approved provider; and
  • if the service is a residential care service:
    • information compiled by the approved provider and provided to the Department about the quality of residential care (National Aged Care Mandatory Quality Indicators); and
    • feedback on matters related to the quality of food (e.g. changes made to the quality of food, food preparation models and menu assessments).^[10]

  The QC Advisory Body is not expected to provide the governing body direct feedback or advice on individual matters, complaints and consumer feedback, but rather is responsible for providing feedback on larger issues and trends regarding the quality of care delivered by the approved provider. ^[11]
  
  

  Practical tips and things to consider

  Develop clear written guidance for the QC Advisory Body, which may include the following:

  • its purpose;
  • its role and responsibilities;
  • membership requirements (including the length of time that a person can be a member);
  • the process of appointment or selection of members;
  • membership expectations and commitments (e.g. minimum term commitment, attendance at meetings, declaration of conflicts, etc);
  • accountability and reporting responsibilities;
  • meeting requirements;
  • remuneration and reviews.
• What assistance do providers need to provide to the QC Advisory Body?

  For the QC Advisory Body to operate effectively, it is expected approved providers will need to provide sufficient information, or enable the QC Advisory Body to obtain sufficient information about the provider’s aged care services in order for the QC Advisory Body to prepare a report to the governing body. Under the legislative requirements, approved providers must provide the QC Advisory Body with information about the quality of care at the service, if requested by it to do so.^[12]

  Relevant information which a QC Advisory Body may request would include:

  • feedback from consumers and representatives;
  • continuous improvement plans;
  • compliance notices from or regulatory actions taken by the ACQSC;
  • staffing arrangement information; and
  • complaints made in relation to the services.

  Approved providers should consider matters such as (among other things), privacy and confidentiality, conflicts of interests and accessibility of information.

  Essentially, the support provided by the approved provider to the QC Advisory Body is intended to ultimately assist the governing body to make meaningful decisions which impact service provision. As a result, it is in the interests of the approved provider to be responsive to requests from the QC Advisory Body and to discuss any additional information which may be useful for the completion of their report.

  Practical tips and things to consider

  • Establish clear documented processes for a QC Advisory Body to obtain information. Consider timeframes, who will be responsible for responding to requests and producing the information.
  • Providers are not expected to produce summaries or additional information reports specifically for a QC Advisory Body. Consider the ways in which you may respond to requests from the QC Advisory Body with existing information or documents. For example, take into account confidentiality of information or whether information should be de-identified to protect the privacy of consumers, personnel and others.
  • Provide information in a format accessible to all QC Advisory Body members.
  • The governing body may identify any particular topics it would like the QC Advisory Body to consider, however care should be taken to ensure that the independence of the QC Advisory Body is maintained.
• Do providers need to form a new advisory body if they already have committees and feedback systems in place?

  Existing providers are not required to replace or rename any existing committees or bodies which fulfil similar functions to a QC Advisory Body. However any existing committee or body which fulfils the role of a QC Advisory Body must also comply with membership requirements and responsibilities of a QC Advisory Body.

  Practical tips and things to consider

  • Existing governance committees which may focus on clinical areas or quality of care may have a more limited scope than what is required for a QC Advisory Board but it is important to assess if there are any other existing committee arrangements which may be modified to meet the legislative requirements.
  • Providers must maintain records of compliance with the QC Advisory Body requirements. It is important to ensure that the governing body has (and can demonstrate that it has) genuinely engaged with the feedback from the QC Advisory Body and has records of matters including (among others):
    • reports and documents provided by QC Advisory Body to the governing body;
    • the ways in which the feedback from a QC Advisory Body has informed decisions made by the governing body;
    • responses from the governing body to the QC Advisory Body.
• Consumer Advisory Bodies

  From 1 December 2023, existing providers must also offer to consumers and their representatives the opportunity to establish a Consumer Advisory Body to give the governing body feedback about the quality of the care provided.

  This written offer must be made a least once every 12 months (even if one already exists).

  If a Consumer Advisory Body is formed, the governing body is required to consider the Consumer Advisory Body’s report or any feedback when making decisions in relation to the quality of the aged care.

  The governing body should then advise the Consumer Advisory Body, in writing, as to how the governing body considered the report or feedback it provided.

  For new providers, these obligations commenced on 1 December 2022.

^{[1] Aged Care Act 1997 (Cth), s 63-1D(1). [2] Royal Commission into Aged Care Safety and Quality, Final Report: Care, Dignity and Respect, https://agedcare.royalcommission.gov.au/publications/final-report, recommendations 88 to 91. [3] Aged Care Act 1997 (Cth) s 63-1D(6)(a)(i); Accountability Principles 2014 (Cth), s 53B. [4] Aged Care Act 1997 (Cth) s 63-1D(6)(a)(ii); Accountability Principles 2014 (Cth), s 53C. [5] Aged Care Act 1997 (Cth) s 63-1D(6)(a)(iii). [6] Aged Care Act 1997 (Cth) s 63-1D(6)(b). [7] Aged Care Quality and Safety Commission Act 2018 (Cth) s 8B. [8] Accountability Principles 2014 (Cth) s 53B(2). [9] Aged Care Act 1997 (Cth) ss 63-1D(6)(a)(ii), 63-1D(7); Accountability Principles 2014 (Cth) s 53C. [10] Accountability Principles 2014 (Cth) s 53C(2). [11] Provider responsibilities relating to governance – Guidance for approved providers (30 November 2022), https://www.agedcarequality.gov.au/resources/provider-responsibilities-relating-governance-guidance-approved-providers p 28. [12] Aged Care Act 1997 (Cth) s 63-1D(8).}