Strengthening Provider Governance Reforms – December 1st approaching fast

The Aged Care Quality and Safety Commission (ACQSC) have been working to improve governance and accountability across the sector. This includes amendments to the Aged Care Act and the Aged Care Quality and Safety Commission Act to strengthen the governance arrangements of approved providers. From 1 December 2023, providers approved before 1 December 2022 must:

  • Ensure their governing bodies consist of a majority of independent non-executive members that have a mix of skills and experience and that at least one member has experience in providing clinical care.
  • Establish and continue a Quality Care Advisory Body.
  • Offer annually to consumers to establish a Consumer Advisory Body.
  • Prioritise older Australians (not the holding company) if the organisation is a wholly owned subsidiary.
  • Ensure engaged workers have the appropriate qualifications, skills and experience to deliver quality care and services.

These reforms include some changes that have already been implemented. All approved providers now must:

  • Assess the suitability of key personnel at least once a year.
  • Submit material changes, including key personnel notifications, within 14 days.
  • Submit provider operations reports annually (first report was due 31 October 2023).

As Critical Success Solutions (CSS) emailed last month – the themes that a recent ACQSC monitoring visit focused on where:

  • Verification of 24/7 RN Exemption: The ACQSC assessed whether the 24/7 RN exemption received from the Home was accurately implemented as per the submission.
  • Assessment of Quality and Safety: The visit aimed to ensure the ongoing provision of quality and safe care by consulting with staff and residents.
  • Examinations: The ACQSC examined clinical care, the Serious Incident Response Scheme (SIRS) incidents, complaint handling and emergency response and escalation procedures.
  • Risk-based Questions: Specific risk-based questions were tailored to issues related to the 24/7 RN exemption.
  • Document Review: The assessors requested various documents, including handover sheets, risk registers, incident reports, clinical governance framework, staff records, minutes, job ads and more related to the examined areas.
  • Monitoring and Verification: The assessors were interested in the continuous monitoring and validation of information entered into the roster portal.

How can CSS assist?

CSS can work with you, your Board and workforce to ensure that they are ready for the 1 December 2023 governance reforms deadline and for assessor visits. CSS can assess your governing body governance capability as well as prepare your staff for potential questions and focus areas.

Contact Critical Success Solutions to assist you with your governance requirements and to tailor support to your needs.

Contact: Alex Pirozzi, Business Manager
Email: or
Mobile: 0448 672 118 or Office: 02 90520292

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