Aged Care Standard 8 Good Governance
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Aged Care Standard 8 and the need for good governance

 

Good governance is important in ensuring that older people using aged care services are confident that their care needs will be identified and addressed, and that input based on their experience will be actively sought by the organisation. Organisational and clinical governance is essential in providing safe, inclusive and quality care at the end of life. This In Focus addresses Standard 8: Organisational governance. Systems and processes are important as is organisational culture and a capacity to engage meaningfully with aged care consumers. There are palliAGED resources that can help you and your aged care organisation.

 

Standard 8: Organisational Governance

Standard 8 recognises that the service’s governing body is responsible for the delivery of safe and quality care and services. It is more than having appropriate governance systems, it is about how these systems support and enable quality care and services. Such systems and structures need to drive and monitor improvements that address the needs of the older person and the quality of care. Consumers should also be engaged in the development, delivery and evaluation of care and services. 

Standard 8 also outlines requirements around clinical governance and specific clinical indicators. 

 

 

Standard 7 Icon - Feedback and complaints

"I am confident the organisation is well run. I can partner in improving the delivery of care and services."

Consumer outcome statement for Aged Care Standard 8. Source: Aged Care Quality and Safety Commission website. The use of this image does not constitute an endorsement by the Aged Care Quality and Safety Commission of palliAGED activities.

Organisational governance and the end of life

Aged care facilities are places where people die and people in receipt of home care packages may also be cared for and die in their home. Older people need to be confident in the services and care they will receive, the workforce needs to understand how care for those with palliative care needs can be provided in a safe, inclusive and timely way care, and the governing body needs to ensure that system and processes are in place to deliver and evaluate care at the end of life.

Our latest palliAGED Aged Care Standards Insight looks at organisational and clinical governance systems in hospitals and aged care and how they can support safe, inclusive and quality care at the end of life. Given an ageing population, and given Australians are dying older and often while involved with an aged care service, governance arrangements within aged care need to address end of life.

 

"The organisation's governing body is accountable for the delivery of safe and quality care and services."

Organisation statement for Aged Care Standard 8. Source: Aged Care Quality and Safety Commission website. The use of this image does not constitute an endorsement by the Aged Care Quality and Safety Commission of palliAGED activities.

palliAGED resources for Standard 8

Quality care at the end of life is important in the last months and weeks of life as well as during the period when the person is dying. Good care supports the person, their family and friends as well as those involved in providing domestic and clinical care. The governance processes are critical in ensuring that there is a respectful culture, good clinical practices, and appropriate accountability.

In Focus Aged Care Standards

Standards provide a statement of the expected level of care that someone can expect from an organisation providing a good or a service. palliAGED has published an In Focus series providing a summary of considerations relating to each of the Aged Care Quality Standards in the context of palliative care at the end of life. In particular, governance processes need to support consumer choice and dignity and this essential organisational understanding is addressed in In Focus Standard 1.

Advocacy

Advocacy is a process of supporting and enabling people to express their opinions and concerns, to access information and services, to defend and promote their rights and responsibilities, and to explore choices and options. This is important with respect to end of life so that each older person has access to the resources and services they need and to ensure their autonomy and wishes are protected. The aged care workforce has an important role in ensuring aged care consumers are aware of their rights and have avenues to contribute to planning, delivery and evaluation of care and services. In Focus Standard 7 looks at Human Resources and the need for a skilled and qualified workforce There is also an evidence overview and practice resources relating to advocacy.

Australian Context

People involved in governance roles including those holding a position on the Boards of Aged Care Services need to have a good understanding of the Australian context for aged care and palliative care. The Australian Context pages provide an overview of issues relevant to governance including an overview of Australia’s aged care system, information on specific population groups, consumer influences and trends, and policy directions in palliative care.

Dignity and Quality of Life

There is a complex interrelationship between dignity, autonomy and personal identity. This also interplays with risk which is a key issue for consideration in organisational and clinical governance processes. These issues were also discussed in the February palliAGED Insight article on Living well until death (107kb pdf). There is an evidence overview and practice resources in dignity and quality of life.

Elder Abuse

Standard 8 requires organisations to have systems to provide protections and safeguards to ensure that older people are free from exploitation, violence and abuse. There is an evidence overview and practice resources providing information about elder abuse.

For the Community

Standard 8 actively represents the importance of the older person in all aspects of governance systems and processes. Family and friends are part of the care system for the older person and become increasingly important at the end of life. There is a Community section within palliAGED that links to resources for family members and for others in the community who will be involved in care and decision making at the end of life.

Practice Tip Sheets

The following palliAGED Practice Tip sheets may also be helpful in ensuring quality care

Talking within the Aged Care Team:

 

There are also a large number of Practice Tip sheets dealing with clinical issues which are important in palliative care.

ELDAC Residential Aged Care Toolkit

The Support Systems and Quality Improvement pages in the Organisational Support section of this toolkit has materials on policies and procedures that can help build a framework for end of life care. The Support Systems and Quality Improvement pages in the Organisational Support section of this toolkit has materials on policies and procedures that can help build a framework for end of life care.

 

Read some of our Palliative Perspectives blogs related to aged care and end of life:

Diversity considerations for advance care planning

Dr Georgia Rowley from ELDAC discusses Australia's diverse population and how diversity considerations should be made when engaging in ACP initiatives.

SHARE - Shared Health and Advance Care Record for End of life choices

Alison Stoker, Palliative Approach Project Officer at Western NSW PHN discusses their ‘SHARE’ project and activities in implementing a shared Palliative Approach across Far West and Western NSW.

Australia must improve palliative care for people with dementia

Palliative care for people living with dementia should be available when and where it is needed.

 

The ELDAC Home Care Toolkit: Resources to manage dying at home

Professor Deborah Parker and Dr Holly Mack explain how the toolkit assists in clinical care, education and learning and organisational support.

Nurse practitioners (NPs) can help integrate the new Aged Care Quality Standards

Peter Jenkin from Resthaven discusses the role of Nurse Practitioners in helping aged care organisations integrate the new standards into practice, and thus demonstrate compliance.

 

Why quality in palliative care guidance for aged care matters

Given the pressures on the aged care system and the reform agenda currently in play, there is a continuing need to ensure that current evidence and resources are available to guide care provision for older Australians as they approach the end of their life.

Page created 01 June 2020