2015 Aged Care Approvals Round - General Feedback for Applicants Seeking Home Care Places

Competition for new home care places in the 2015 Aged Care Approvals Round (ACAR) was extremely high, with the Department of Health (the Department) receiving applications for over126,000 new home care places in respect of the 6,045 places advertised. This represents approximately 20new places being sought for every one place available.

This document summarises some of the common reasons why applicants seeking an allocation of home care places in the 2015ACAR were not successful. It also provides information on areas where less competitive applications could have been strengthened. This feedback draws on the applications received by the Department in the 2015ACAR.

Assessment framework

The allocation of new aged care places is made by the Department in accordance with the provisions of section 14.1 (Allocation of places) and section 14.2 (Competitive assessment of applications for allocations) of the Aged Care Act 1997 (the Act) and the associated Allocation Principles 2014, Quality of Care Principles 2014, User Rights Principles 2014and Aged Care (Transitional Provisions) Act 1997.

In accordance with these provisions, places are allocated to those applicants that, through a competitive assessment process, demonstrate they best meet the needs of the aged community in an aged care planning region.

The 2015 Aged Care Approvals Round Essential Guide(the Essential Guide), that was published on the website as part of the Invitation to Apply for places, contained information for applicants to assist in determining whether to apply for government funded places, and how to complete the relevant application form. It included, among other things, the matters that the Department takes into account in determining whether to allocate places, and a guide to the information that should be provided in an application.

In endorsing their application(s), applicants certified that they had read the relevant sections of the Essential Guide and were aware of their responsibilities as prescribed in the Act and the associated Aged Care Principles.

As stated in the Essential Guide, in assessing an application the Department:

  • considered the information provided by the applicant;
  • considered an application in the light of the requirements of:
  • the Act;
  • the Aged Care Principles;
  • policy or procedural information detailed in the Essential Guide; and
  • may have considered any other relevant information available to the Department including, but not limited to:
  • the Aged Care Complaints Scheme;
  • the Australian Aged Care Quality Agency;
  • information provided to the Department through other assessment processes; for example, any application to transfer, vary or exchange existing places; and
  • any strategies the applicant may have put in place to improve compliance with Australian Government requirements.

Targeting of regions

As explained in the Essential Guide, the Regional Distribution of Aged Care Places (RDoACP) provided a guide to the number of places available across aged care planning regions; however, this may not be the final number of places allocated in each region. Applicants were able to apply for home care places in any aged care planning region, including those regions not specifically identified in the RDoACP. The final allocation of places reflected the best use of the available places as a result of the overall assessment, including the quality of applications received.

Common reasons applications were not successful

The 2015 ACAR was highly competitive with strong interest from providers in all advertised regions. This meant that while some applications were rated highly, not all applications received places.

Other common reasons why an application may not have been successful were:

  • the applicant did not demonstrate that its management and/or service delivery workforce had sufficient relevant experience or expertise;
  • the applicant did not demonstrate a strong understanding of the requirements of service delivery under aged care legislation. For example, ensuring quality of care in service delivery or protecting the rights of care recipients; and
  • the applicant failed to demonstrate that the proposal in their application best met the needs of the Aged Care Planning Region.

Further feedback is provided below against the assessment criteria, divided into sections for Organisation Details and Service Details. While these criteria are presented separately in this document, it should be noted that applicants often addressed the criteria throughout their applications in answers to one or more questions. All relevant information provided by an applicant was taken into consideration as part of the assessment process.

Structure of the application form

To apply for home care places –applicants were required to complete Part A once per approved provider entity and Part B for each service in each Aged Care Planning Region where places were being sought.

The Part A application form required applicants to respond to questions at the approved provider level. The Essential Guide directed applicants to frame their responses across their organisation.

The Part B application form required applicants to respond to the questions at the service level. The Essential Guide directed applicants to provide specific details in relation to the expansion or establishment of their proposed service.

Applicants that addressed this requirement in the application were often more competitive than those that did not.

PartA– Organisational Details

2.1 –Expertise and Experience (Management and Staff)

Criterion / Expertise and Experience (Management
and Staff)
Relevant question / 2.1
Legislative reference (Allocation Principles 2014) / Part 4, Division 2, 28 (1)(a)

Applicants were asked to:

Provide a detailed description of the organisations’ board and/or senior management’s relevant expertise and experience in aged care, or other services.

Suggested areas for improvement:

In the Essential Guide, applicants were asked to note that relevantexpertise and experience was not limited to the provision of home care.

Applicants with experience in providing other aged care or residential services (such as organisations with experience in managing retirement villages) were also encouraged to apply for home care places.

Applicants could have strengthened their responses by providing comprehensive information in the following areas:

  • the relevant experience, qualifications and skills of management staff of the aged care organisation, and the roles that these staff would perform;
  • how the experience, qualifications and skills of the organisation’s management team contributed to ongoing improvement of the day-to-day management of the organisation and staff management and retention strategies; and
  • experience (if relevant) the organisation had in care delivery through other government programmes.

2.2 –Ability of the Applicant to Monitor and Continuously Improve Aged Care Services

Criterion / Ability of the Applicant to Monitor and Continuously Improve Aged Care Services
Relevant question / 2.2
Legislative reference (Allocation Principles 2014 and Quality of Care Principles 2014) / Part 4, Division 2, 28(1)(c)
Part 3, Divisions 1& 2

Applicants were asked to:

Describe how the organisations’ board and/or senior management will:
a)monitor the performance of your aged care services, or other services;
b)oversee continuous improvement across your aged care services, or other services; and
c)manage risk (e.g. mitigation strategies).

In the Essential Guide applicants were required to demonstrate, with reference to the approved provider responsibilities outlined in the Act and Quality of Care Principles 2014 (for example the Home Care Standards), the reporting systems in place to enable the board and/or senior management to monitor the performance of the organisation, oversee continuous improvement and manage risk.

Suggested areas for improvement:

Applicants could have strengthened their responses by providing comprehensive information, including:

  • reporting systems and management strategiesthe applicant had/would put in place to monitor performance of services that areconsistent with the standards required under the Act, Aged Care Principles and Home Care Common Standards;
  • details of audit report processes/protocols, frameworks for risk management and reporting;
  • description of policies the provider had/would put in place to eliminate/reduce risk; and
  • information on systems to track identified risks.

2.3 –Measure to Protect the Rights of Care Recipients

Criterion / Measure to Protect the Rights of Care Recipients
Relevant question / 2.3
Legislative reference (Allocation Principles 2014 and User Rights Principles 2014) / Part 4, Division 2 28(1)(f)(i) and
Part 3, Division 2
Part 3, Division 3
Part 3, Division 4

Applicants were asked to:

Provide examples of how the organisation will ensure the rights of care recipients are protected.

Suggested areas for improvement:

Applicants could have strengthened their responses by providing details of the practical steps they had taken, or would take, to meet the requirements of the User Rights Principles 2014, including:

  • what information (if any) regarding security of tenure is provided to care recipients/representatives prior to the commencement of care (and an outline of the process);
  • comprehensive information on access to care recipients by representatives, advocates and community visitors;
  • the provision ofinformation demonstrating the applicant’sunderstanding of theCharter of Care Recipients’ Rights and Responsibilities - home care;
  • detail on how an applicant’s fees and charges policy would be explained to their care recipients and recipients’ representatives, including the ability to negotiate fees, changes to fees and charges and applicants assessment of ‘capacity to pay’;
  • information regarding home care agreements;
  • detail on complaints procedures within the organisation;
  • measures that would be taken to protect a care recipient’s privacy; and
  • communications strategies, including the information of care recipients and their representatives regarding changes in fees and charges.

2.4 –Diversity of Choice – Special Needs
and/or Dementia

Criterion / Diversity of Choice – Special Needs and/or Dementia
Relevant question / 2.4
Legislative reference (Allocation Principles 2014) / Part 4, Division 2 28(1)(f)(ii)

Applicants were asked to:

Describe the organisations’ approach to ensure appropriate care is delivered to people with special needs and/or dementia.

Suggested areas for improvement:

All applicants in answering this question should have considered how they would provide care to the nine special needs groups identified in section 11-3 of the Act.

Applicants were also required to demonstrate how they intended to provide care for people living with dementia. Responses were required to include practical examples of how the applicant had, or would, provide care of this nature, including:

  • how the applicant would provide care in relation to the particular physical, social and spiritual and environmental needs of care recipients, including how the applicant identified these issues/needs;
  • how the applicant would ensure the availability of suitably trained staff to meet these particular care needs;
  • strategy for managing challenging behavior, including prevention, minimisation, escalation prevention and care recipient/staff safety;
  • evidence of established linkages with relevant communities and/or key organisations in their nominated region or identified geographical location; and
  • information on how the applicant would ensure the safety of care recipients and staff.

Part B – Service Details

3.1 – Service Proposal

Criterion / Service Proposal
Relevant question / 3.1
Legislative reference (Allocation Principles 2014) / Part 4, Division 2, 28 (1)(b)

Applicants were asked to:

Provide a detailed description of the proposal for this service

Suggested areas for improvement:

Applicants could have strengthened their responses by providing detailed information on their service proposal and service’s processes, including:

  • information (if relevant) on any innovations being proposed and their effect on care recipients;
  • details of the service delivery model, including staffing levels;
  • information on how the service would deliver care on a Consumer Directed Care (CDC) basis;
  • evidence of established linkages with relevant communities and/or key organisations in their nominated region or identified geographical location;
  • how the service would complement existing services in the region; and
  • how the service supports wellness or re-enablement approaches and promotes independence.

3.2–Ability of the Applicant to Provide the Appropriate Level of Care

Criterion / Ability of the Applicant to Provide the Appropriate Level of Care
Relevant question / 3.2
Legislative reference (Allocation Principles 2014) / Part 4, Division 2, 28(1)(c)

Applicants were asked to:

Provide a detailed description of:
a)what aged care needs will be met, and how you will address them;
b)what evidence has been relied on to demonstrate the aged care need(s) in the region.

Suggested areas for improvement:

Applicants could have strengthened their responses by providing detailed information on their service proposal and service’s processes, including:

  • details of the need in the aged care region and geographical area for which the service is proposed and how the service would meet these needs;
  • how the organisation has met similar needs with other services (if relevant);
  • evidence of any research or consultations performed to support the application; and
  • details of any measures/systems that had been, or would be, put in place to ensure staff are able to provide care consistent with aged care legislation and to ensure staff understand their responsibilities under this legislation;

3.3–Continuity of Care

Criterion / Continuity of Care
Relevant question / 3.3
Legislative reference (Allocation Principles 2014) / Part 4, Division 2, 30

Applicants were asked to:

Provide examples of how the service will provide continuity of care for current and future care recipients.

Suggested areas for improvement:

Applicants could have strengthened their responses by providing comprehensive information on:

  • utilisation of a mix of places to manage the changing needs of care recipients (if applicable); and
  • management of the transition of care recipients (e.g. care recipients admission and return from hospital or residential respite care) through coordination with other care providers and/or community services andhow continuity of care for care recipients moving between services would be ensured.

3.4- Provision of Appropriate Care for People with Special Needs

Criterion / Provision of Appropriate Care for People With Special Needs
Relevant question / 3.4
Legislative reference (Allocation Principles 2014) / Part 4, Division 2, 28(1)(f)(ii)

Applicants were asked to:

Describe the measures the service will use to deliver appropriate care to targeted special needs groups and/or key issues identified as being a priority at 2.4.

Suggested areas for improvement:

All providers of home care are expected to be able to deliver appropriate care to people from special needs groups as part of their normal service delivery. In responding to this criterion, applicants could have strengthened their responses in applications for places for any special needs group by providing comprehensive information to demonstrate how they would:

  • provide care in relation to the particular physical, social and spiritual and environmental needs of care recipients, including how the applicant identified these issues/needs;
  • ensure the availability of suitably trained staff that are able to meet these particular care needs (e.g. information on recruitment policy and staff development programs targeting specific special needs groups) and also ensure that existingand new staff are suitably trained, including cultural awareness training for care and volunteer staff;
  • organisational experience and/or expertise in the provision of care to the special needs group/s; and
  • establish linkages with relevant communities and/or key organisations in their nominated region or identified geographical location.

The following information has been divided into separate sections for each special needs group.

Special Needs Groups

People from Aboriginal and Torres Strait Islander communities

Applicants could have strengthened their response for places by providing detailed information on:

  • awareness (and, where relevant, facilitation) of customs and traditions, including bereavement customs, commemoration of Aboriginal and Torres Strait Islander days/events of cultural significance, and recognition of different responses Aboriginal and Torres Strait Islander people may have to mainstream days and events of cultural significance; and
  • translated information and provision of interpretation services and information.

People from Culturally and Linguistically Diverse (CALD) backgrounds

Applicants could have strengthened their response for places by providing detailed information on:

  • awareness (and, where relevant, facilitation) of customs and traditions, dietary requirements (including culturally appropriate diets), commemoration of days/events of cultural, social and spiritual significance;
  • staffing issues, including employment of bi-lingual staff and cultural awareness training for care and volunteer staff;
  • translated information and provision of interpretation services and information provided in easily understood plain language; and
  • home care agreements provided written in the care recipient’s primary language.

People who live in rural or remote areas

Applicants could have strengthened their response for places by providing detailed information on:

  • understanding of social isolation issues, including how the applicant would assist care recipients to reduce social isolation; and
  • how the applicant would establish and maintain connections with other rural community activities.

People who are financially or socially disadvantaged

Applicants could have strengthened their response for places by providing detailed information on:

  • how the applicant would assist care recipients’ liaise with Centrelink and other government welfare organisations, as well as non-government support groups;
  • how the applicant would manage a transient population;
  • provision of information to care recipients that can be easily understood;
  • how the applicant would assist care recipients with budgeting and income management; and
  • how the applicant would assist care recipients to reduce social isolation.

People who are Veterans

Applicants could have strengthened their response for places by providing detailed information on:

  • the applicant’s knowledge and understanding of health problems/issues particular to veterans, including mental health and post-traumatic stress disorders;
  • the applicant’s awareness of higher incidence of early-onset dementia experienced by veterans; and
  • how the applicant would assist veterans to maintain contact with fellow veterans and veterans’ organisations.

People who are homeless or at risk of becoming homeless