Care-Metric, in collaboration with the DAA Group and Massey University, has undertaken a study of audit results for aged care services. The study (see Abstract below) shows that compliance with the standards of care in aged care facilities has improved over four years.
The study, which has been published in Kai Tiaki Nursing Research, looked at 185 aged care facilities that were audited in 2016 and compared the results with their previous audit. The results are good news for residents, family and staff. The scores were not influenced by which organisation performed the audit, and this demonstrates the robustness of the outcomes.
The review of audit outcomes by DHB regions shows that facilities in the Northern and Southern region showed a significant improvement in the overall scores. This was in contrast to those in the Midland and Central region. Of the six standards contained within the Health and Disability Services Standards, four significantly improved and two did not (Organisation Management and Restraint Minimisation and Safe Practice). Of the six standards, Organisation Management and Continuum of Service Delivery had the lowest scores.
The study in itself is unique for several reasons:
- A similar study has never been published in New Zealand before;
- It shows the power that publicly available data has;
- It provides direction on which parts of the standards the sector need to focus on (ie Organisation Management, Continuum of Service Delivery).
Interestingly, improved compliance with the standards has not led to an increased perception of the quality of care by the public, as seen in recent media reports. This demonstrates the limitations of the audit process, which is only one item in a toolbox of tools to monitor the quality of care. The authors suggest, therefore, that measures that are observable and relate to the concept of quality of care of the general public (e.g. nutrition, continence and pain management, prevention of falls and pressure injuries and wound care) should be incorporated into the monitoring processes. This could be a first step in closing the gap in the perception of performance between the age care facility and the public that they serve.
What factors influence compliance with health and disability service standards for aged residential care in New Zealand?
Aims: To identify compliance with the New Zealand government’s health and disability service standards (HDSS) in aged residential care (ARC) facilities in 2016, compared with previous years’ outcomes, and its relationship with the surge of complaints in the public domain.
Methods: The 2016 audit reports of 185 ARC facilities were compared with their previous audit reports. The level of attainment of the different service groups was quantified (5:continuous improvement — 1:unnattained).
Results: Audit reports of 185 facilities were included for analysis. Overall, the compliance with the standards improved from an average of 3.59 (plus or minus 0.80) to 3.76 (plus or minus 0.71). All service groups improved significantly over time, except for organisation and management. Number of beds and audit agency had no significant influence on the outcomes.
Conclusions: Compliance with the HDSS of the ARC facilities audited in 2016 significantly increased from their previous audit. There appears to be a discrepancy between the outcome of this study and the perception of the public; however this study could not draw conclusions whther this this discrepancy is directly related to an increase in poor performance. The question emerges whether the current standards reflect sufficiently the provision of good quality care.
Weststrate J, Boamponsem L, Cummings L, Towers A. (2019) What factors influence compliance with health and disability service standards for aged residential care in New Zealand. Kai Tiaki Nursing Research, 10(1), 31-37.
Jan Weststrate, RN, PhD, is a director of Care-Metric (health service quality improvement advisers), Raumati, New Zealand. His correspondence address is: Jan@care-metric.com
Louis Boamponsem, PhD, is a quality assurance officer for the Laura Fergusson Trust (rehabilitation and support services), Canterbury & West Coast, New Zealand.
Cathy Cummings, RN, DBA, is director and specialist advisor for the DAA Group (health certification and accreditation), Wellington.
Andy Towers, PhD, MA, is a senior lecturer in the School of Health Sciences, Massey University, Palmerston North, New Zealand.