Background to published Aged Care Quality Agency (AACQA) report.
It’s important to understand that some of the information reported on the AACQA website has been successfully challenged by St John’s and deemed incorrect, but process allows it still to be published. This incorrect information particularly applies to the management of residents’ pain and wounds as detailed in the Audit Reports. It has proved to be inaccurate.
The Audit Reports are recommendations from the AACQA Assessor’s at the conclusion of the review audit to the decision maker (Delegate) within the AACQA. Copies are provided to the organisation being audited and the AACQA Delegate.
The process allows the organisation being audited to make a submission to the AACQA Delegate concerning the Audit Report. On the basis of the Audit Report and organisation’s submission the AACQA delegate makes a decision on which Expected Outcomes are met or not met. The AACQA then publishes the Audit Report and the Delegates decision.
The Assessor’s Audit Report for the facility known as the Nursing Home (RACS ID 4481) recommended the AACQA Delegate find 17 Expected Outcomes as not met. The AACQA Delegate found 13 Expected Outcomes to be not met for the Nursing Home.
The Assessor’s Audit Report for the facility known as the Hostel (RACS ID 3293) recommended the AACQA Delegate find 14 Expected Outcomes as not met. The AACQA Delegate found 12 Expected Outcomes to be not met for the Hostel.
Overall St John’s Village has 13 not met Expected Outcomes; 12 of the 13 not mets in the Hostel are the same Expected Outcomes in the Nursing Home.
On the basis of the submission St John’s Village provided the AACQA Delegate found Expected Outcomes ‘2.8 Pain Management’ and ‘2.11 Skin Care’ to be met. The information provided to the AACQA Delegate satisfied her that residents did not die in pain, and that residents wound care was attended to. The statements contained in the Audit Reports relating to these Expected Outcomes has proved to be inaccurate.
On the basis of St John’s Village’s submission, the AACQA Delegate was also satisfied that Expected Outcomes ‘1.3 Education and staff development’ and ‘1.8 Information Systems’ were also met.
St John’s Village Response to Audit Assessment:
St John’s Village underwent a review audit at the direction of the Minister for Ageing Ken Wyatt between 19 September and 4 October. This review audit was requested following the deaths of 10 residents at St Johns village who had contracted influenza during the influenza outbreak. Nine residents who died had tested positive to Influenza A, one resident who died had tested positive to parainfluenza.
It is important to note that most of St John’s Village’s residents have high care to sub-acute clinical care needs; as such the residents who contracted influenza during the outbreak already had significant medical issues and were clinically compromised.
While noting the unique circumstances arising from this year’s influenza outbreak, St John’s Village fully recognises the need to ensure that it has systems and procedures that can fully withstand such challenges and is committed to rectifying other gaps identified in the report as a matter of urgency.
St John’s Village has been working closely with an experienced Nurse Advisor. The Nurse Advisor is Co-chair of the Infection Control Response & Quality Project Working Group, who is tasked by the Board with rectifying the gaps identified by AACQA. The Nurse Advisor, together with her expert team, are working closely with the clinical staff to review the organisation’s systems to identify any gaps and implement the Plan for Continuous Improvement to address any deficiencies. This team will remain at St John’s Village until it achieves full and sustainable compliance with each of the 44 Expected Outcomes of the Accreditation Standards.
In the early days of the influenza outbreak, the Board was very concerned about the influenza outbreak and its effect on residents and staff. Consequently, the St John’s Village Board instituted a comprehensive review of infection control, clinical care and quality processes against the 44 Expected Outcomes of the Accreditation Standards (part of the Aged Care Act 1997). This review, known as the Infection Control Response & Quality Project (the Project), commenced work two weeks prior to the review audit and is being overseen by the Infection Control Response & Quality Project Working Group (the Working Group). The Working Group reports directly to the Chair and Board of St John’s.
St John’s Village Restricted Staffing:
Out of a staff of 170, 53 staff were affected by the influenza; this had a very significant impact on those staff who were available to work at St John’s Village.
Due to the unprecedented severity of the flu season and despite its best efforts, St John’s Village was, on occasion during the influenza outbreak, short-staffed due to staff illness. Though agency staff were brought in and St John’s Village’s staff were asked to work double shifts, St John’s Village occasionally experienced difficulty in securing staff because of, amongst other things, the need for staff to receive a medical clearance certificate and be five days symptom-free before returning to work, the fact that staff were prevented from moving between wings so as to minimise the spread of infection, and the need to plan adequate breaks between staff shifts.
National Flu epidemic:
The influenza outbreak put a record strain on Victorian emergency departments, which recorded a 13 per cent increase in daily admissions to about 3,964 admissions each day during August – the highest ever for the month. More than double the numbers of people have been affected by the flu this year. There had been more than 370 confirmed influenza deaths recorded in four states.
Many of these were in aged care facilities. More than 120 elderly Victorians in nursing homes have died from the flu this year, after three horror strains infected more than 14,000 in the state. The 2017 flu season, at its peak, was unprecedented in its severity.
According to the Victorian Infectious Diseases Laboratory, the number of notified laboratory confirmed influenza cases for the year to 20 August 2017 was 31% higher than at the same time in 2016, with most notified cases being influenza type A. It is hypothesised that the 2017 flu vaccination was less effective than in previous years,  which contributed to the spike in cases.
13 November 2017