|Title:||Security of Tenure for Residents of Aged Care Facilities|
|Document ID:||Operational Directive OD 0214/09|
|Date of issue:||Thursday, 27 August 2009|
|Description:||Guidelines to ensure that residents of aged care facilities are returned to the original facility following the completion of an acute and/or subacute inpatient episode of care, even if reassessed as having changed care needs, as mandated under the Aged Care Act, 1997. This will improve the continuity of care for the resident and reduce the risk that the resident will remain in hospital inappropriately or be transferred to a state funded Care Awaiting Placement facility to await permanent placement.|
|Legal requirements:||Aged Care Act, 1997
|Applicable to:||Public Hospital clinical staff involved in discharge planning|
|Framework:||Clinical Services Planning and Programs Policy Framework|
|Period of effect:||from 27 August 2009 to 20 August 2014|
|Review date:||19 August 2010|
|Authorised by:||Dr Peter Flett, DIRECTOR GENERAL, DEPARTMENT OF HEALTH WA, 19-Aug-2009|
|Print version:||View print version|
Security of Tenure for Residents of Aged Care Facilities1. Purpose:
The following guidelines have been developed to facilitate a consistent approach for WA Health services when working with patients who are existing aged care residents and whose ongoing care needs have changed.
The Commonwealth Government administers the Aged Care Act 1997, including the performance of aged care service providers, via the Department of Health and Ageing. The Act clearly defines the obligations of aged care providers in relation to Security of Tenure (see http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-mailfax-2008-2901.htm), which include the requirement that aged care providers ensure that appropriate alternative accommodation is available for an existing resident before that resident can be required to leave the aged care service. This includes residential aged care provided as part of a Multi-Purpose Service (MPS).
Security of Tenure applies even if the resident’s ongoing care needs have changed, including requiring a higher or more complex level of care than the provider can routinely administer using its normal care provision model, while a more appropriate alternative is developed or ongoing care at the required level is maintained. Please note that hospital is not considered to be appropriate alternative accommodation.
Despite this requirement, there have been occasions in which residents of an aged care facility have been admitted to a public hospital and, when assessed as having changed ongoing care needs, have not been re-accepted by the aged care facility when the resident has completed her or his acute and sub-acute care.
While the number of occasions in which this situation occurs is not high in relation to the total number of admissions to public health services, the period of time an existing aged care resident spends as Care Awaiting Placement (CAP) in a health service or CAP facility can be significant. It means that the patient must await permanent placement while in a temporary facility that is not her or his home, without the support of carers who are familiar with her or his needs. It can also increase the risk of access block within public health services.
Compliance with the existing requirements of the Aged Care Act 1997 in regards to Security of Tenure is one of a number of strategies designed to minimise potential negative impacts on hospital ALOS, and to ensure that existing aged care residents are cared for in an environment that best meets all of their needs.
3. Responsibilities of Health Services:
As in all good discharge planning, the care needs of the patient must take priority and planning should start as early as possible in the acute episode. Some aged care facilities will not routinely be able to provide for any changes in the ongoing care needs of a resident. All aged care facilities will need clear, detailed and specific information about what a returning patient’s care needs are, with particular emphasis on identifying any changes from the patient’s pre-morbid functioning. The facility may also need a realistic timeframe to set up additional specialised care services, such as a Registered Nurse to provide wound care, administer medications, etc or additional carer hours to provide increased assistance with feeding, personal care, etc. Under the User Rights Principles, it would be the aged care service provider’s responsibility to broker and fund these services until the patient leaves the facility, should an appropriate alternative be necessary.
If a patient, who is an existing aged care resident, is assessed as having changed ongoing care needs, including requiring high-level residential aged care, the following steps should be taken:
Please direct any queries from patients, their carers or families to the Aged and Community Care Information Line (contact number below) in the first instance.
Dr Peter Flett
This circular last updated: Wednesday, 26 August 2009 at 3:42pm