Getting started with the QCAB and CAB

CSS has had many request for support and assistance in the development and implementation of a board governance program within Approved Providers (AP) of aged care. 

In the past couple of weeks I attended the ACCPA conference in Sydney and the National Provider in Melbourne. It was clear during the conferences that the Aged Care Governance Reforms are now progressively being implemented and many providers are now working through the logistics of what 1 December 2023 means for them. I have to say I was surprised at the number of providers who I spoke to who have not started looking at the reform agenda and in particular their governance structures and the QCAB and CAB development. 

In recent weeks the commission has been asking many more questions and information from boards and governing bodies, especially those that are new under the Dec 2022 requirements. Whilst the reforms that have been implemented for new providers (from 1 December 2022) are now embedded and for existing providers we have some time until commencement for existing providers (1 December 2023), it has been interesting seeing the requests for information at quality reviews from the Commission. There has been a focus on components of both corporate and clinical governance. For the new providers who are being assessed against the reforms, the commission is being very prescriptive about what is required as per the legislation.

Reform RequirementCSS Support
Approved providers must set up a QCAB. The QCAB:
+ Must give the governing body a written report about the quality of care for each of its services at least every six months.
+ Can provide feedback about the quality of care to the governing body at any time.
The governing body must:
+ Consider the QCAB report and feedback when making decisions about the quality of care.
+ Write to the QCAB about how its report and feedback was considered.
CSS can:
• Work with the Board and executive in the implementation of the QAB for both residential and home care.
• Document the required changes to the CI Plan and provide an Action Plan to support the implementation of the QCAB.
• Conduct an education program to support the implementation of the program.
• Support the executive to develop the nominated structure of the body.
• Provide a draft Terms of Reference, standing Agenda and associated documentation to support the implementation of the body.
• Develop in consultation with the Board and executive the reporting template and structures of the body.
• Provide CSS senior consultants to support providers by being the Chair of the Advisory Board. All consultants who are nominated as chair have either completed the Company Directors Diploma or Certified Board Advisory Course.
• Perform Board and committee fit tests, including review of multiple individual’s suitability to form part of the advisory body.
Every 12 months, providers must write to all consumers and their representatives to seek interest in establishing one or more CAB.
The CAB must give the governing body a report every 6 months about the quality of care for each of its services.
If a CAB is established, the governing body must:
+ Consider the CAB feedback when making decisions about the quality of care.
+ Write to the CAB about how its feedback was considered.
CSS can:
• Work with the Board and executive in the implementation of the CAB for both residential and home care.
• Document the required changes to the CI Plan and provide an Action Plan to support the implementation of the CAB.
Conduct an education program to support implementation of the program.
• Provide a template Expression of Interest Form for the consumers and representative to consider.
Support the executive on developing the nominated structure of the body.
• Provide a draft Terms of Reference, standing Agenda and associated documentation to support the implementation of the body.
• Develop in consultation with the Board and executive the reporting templates and structures of the body.
Provide education to the formed CAB/s, which will be a critical component to achieve positive outcomes and avoid conflict and misunderstanding.
• Perform committee fit tests, including review of multiple individual’s suitability to form part of the advisory body.

Board governance Self-assessment and Key Personnel Suitability Assessment

CSS has had many request for support and assistance in the development and implementation of a board governance program within Approved Providers (AP) of aged care. We are currently working with APs and their legal teams to ensure all elements of their review of their constitution is in line with the governance reforms. Also, we are assisting providers to undertake the key personnel independent suitability assessment to ensure they meet the requirements of the reforms. We have a Board Governance Self-assessment to assess how you are meeting the requirements and what areas of risk you have within your governance structures.

Building Board capability through Bootcamp Program

Over thew past two months the team at CSS have conducted a number of full day face to face education sessions and/ 2 hour zoom sessions from our bootcamp series for Residential and Home Care Approved Providers and Executive Team members. Feedback from these sessions for Boards and Executive Teams is that they were not aware of their responsibilities as Approved Providers and key personnel. They have also expressed concerns regarding the pending responsibilities under the new reforms and how they will meet these in the future. As I have indicated to all Chairs and CEOs, CSS will walk beside you and build capability in your team so you will be prepared for the changes ahead.

The bootcamp program is tailored for your organisational needs. The following is a list of the key topics, including:  

Module 1 Industry Overview, Legislation, Reforms
1.       Discuss the current state of the industry.
2.       Overview of the legislation relevant to the aged care industry.
3.       Discuss current reforms and new Aged Care Quality Standards.

Module 2 Approved Provider Responsibilities

1.       Discuss approved provider responsibilities.
2.       Detail Key Personnel changes from the current reforms.
3.       Outline some professional standards and the Code of Conduct.

Module 3 Overview Aged Care Quality Standards

1.       Outline the current Aged Care Quality Standards.
2.       Discuss major components of organisational governance Standard.

Module 4 Clinical Governance 

1.       Discuss the requirements of the clinical governance framework.
2.       Outline the issues consumers face including high impact high prevalence risks and dignity of risk.
3.       Discuss the Directors’ clinical governance responsibilities.

Module 5 Significant Requirements in Aged Care

1.       Detailed decision about the board responsibilities in the following key risk domains: Restrictive Practices
2.       Choice and decision making
3.       Incident management and the Serious Incident Response Scheme
4.       Open disclosure

Module 6 Material Risk, Commission, Governance Framework

1.       Discuss the common material risks within aged care
2.       Outline the Aged Care Quality and Safety Commission approach.
3.       Review the common ‘Not Met’ areas and themes.
4.       Recap the new governance provider responsibilities.
5.       Summarise the elements of the governance framework.

Module 7 Development and Implementation of the Consumer and Quality Care Advisory Board (Committee)

1.       Overview of the new requirements for a QCAB and CAB.
2.       Primary functions of the QCAB and CAB.
3.       Membership of the QCAB and CAB.
4.       Reporting for the QCAB and CAB.
5.       Sample Agendas for the QCAB and CAB

Module 8 (OPTIONAL) NDIS Provider Responsibilities in a RACF and Regulatory Issues

1.       Overview responsibilities of RACF who have NDIS participants.
2.       Discuss differences between Aged Care Quality Standards and NDIS Practice Standards.
3.       Outline regulatory differences between aged care and disability sectors.
4.       Overview recent regulatory issues for NDIS in RACF.

Module 9 (OPTIONAL) Home Care Approved Provider Responsibilities and Regulatory changes

1.       Recap approved provider responsibilities – specific to home care.
2.       Home care industry context
3.       Overview recent regulatory issues for home care.
4.       Sustainable Financial management in home care.
5.       5 key risk of home care providers.
6.       Key risk areas from the commission visits.

Module 10 (OPTIONAL) Overview and orientation to CSS Board Governance Manual – discount purchase with this program.

1.       Examine the principles for effective Board performance
2.       Discuss the elements of the CSS Board and Corporate Governance Framework/Manual.
3.       Step through the documents in the requirements of the clinical governance framework.
4.       How to be in front of the pack.

If you would like to have a further conversation with CSS in relation to any of these areas, or have CSS conduct a governance bootcamp program for your board and executive, or help with the QCAB/CAB or access the board governance tool/ support with key personnel suitability assessment send an email to Alex (CSS Business Manager) Alex@cssconsulting.com.au or call 0448 672 118.

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