Safety Culture in the Aged and Disability Service Contexts – Beyond Compliance

Overview About mecwacare Implementation of a integrated framework to provide oversite of mecwacare’s safety culture The Regulatory Context The Situational Context Application to Practice Quality and Risk Management Framework Supporting a Safety Culture – success factors

About mecwacare Not for Profit Founded by volunteers in 1959 Weekly care and support to over 12,000 older people and people with disabilities Services are provided across Melbourne and regional Victoria Over 4 million hours provided per annum Over 365,000 hours of Home Care and Nursing Services per annum More than 1,500 employees and 350 volunteers Dedicated Quality and Risk Department with direct report to Chief Executive Fully accredited and certified services (CCCS - HACC and NRCP; Residential Aged Care Standards; Disability Certification; AS/NZS4801 OHS Management System) Employer of Choice (Workplace Gender Equality Agency)

mecwacare Service Map

The Regulatory Context Federal and State level accountabilities and multiple reporting requirements creates complexity. Uncertainty related to changes in legislation and regulatory frameworks impacting on business, care and service delivery models across the business (e.g. Consumer Directed Care) Challenges satisfying competing regulatory requirements e.g. Provision of a safe working environment whilst supporting consumer choice and independence

The Situational Context Risks are compounded by situational factors: Low skill base among care workers Unregulated care workforce High proportion of CALD staff from Non-English Speaking Backgrounds Ageing workforce with associated age related health issues Employees working for multiple employers in similar roles Isolated work in uncontrolled environments with potential hazards Reliance on Risk Assessments completed by other organisations (e.g. My Aged Care, brokered services) Higher level of care needs among consumers Staying at home for longer Coming into residential care later

Application to Practice Challenges in applying a complex regulatory framework in a complex situational context: Establishing an overarching framework that: can be applied across multiple service areas ensures that component parts are integrated is simple and clear to ensure staff understand their roles and responsibilities and can act accordingly

Quality and Risk Management Framework

Key to effectiveness of the framework is the way component parts work together

Quality and Risk Management Framework Policies and procedures detail role specific responsibilities

Quality and Risk Management Framework Flow charts available to guide staff practice and appropriate response

Quality and Risk Management Framework Risk management focus at all levels of the organisation

Supporting a Safety Culture Keys to successfully supporting a Safety Culture Screening e.g. psychometric testing for carers Set clear expectations of staff e.g. orientation Education, Training and competency assessment Communication and consultation appropriate for staff mix i.e. clear roles and responsibilities, easy to understand Employ specialists to support staff in the workplace Embed a Risk management focus at all levels Robust Information Management systems Rigor in monitoring and review processes Prevention and Early Intervention e.g. wellbeing programs

Outcomes Outcomes across the organisation over a 4 year period: No identified systems issues despite 300% increase in the number of external audits/reviews conducted by external agencies/departments 55% decrease in Reportable/Notifiable Incidents (legislated and/or compulsory reporting requirements) 59% decrease in staff incidents resulting in a new WorkCover claim Staff report high role clarity (in the top 25% of Australian workplaces) (Organisational Climate Survey, Dec 2014) 136% increase in the uptake of annual influenza vaccinations by staff 100% of clinical/care staff competent in manual handling and infection control practices following mandatory orientation program.

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