Glenbrook Rest Home - where every resident counts
Sharon and Peter decided to volunteer for participation in the unannounced spot audit trial, run by the Ministry of Health (MoH). Rest home spot audits will be introduced early 2010. This has come about at least partly as a result of recent negative media publicity. This publicity, based on incidents that did happen in rest homes, was a severely dramatised and sensationalised version of events. The version that sells newspapers and makes easy headlines, usually more based on emotions than on facts.
Spot audits are being presented as unannounced, but they actually take place in the period of three months before and three months after a regular surveillance audit, so withinin a period of six months in all. Not really unannounced. Rest homes normally get audited every three years, with a surveillance audit in the middle, after 18 months. This surveillance audit will now be replaced with 'unannounced' spot audits for which we volunteered to be part of the trial.
The spot auditor appeared on our door step on Thursday Dec 10 for an audit that took 1.5 days.
Some clinical files (care plans, medication charts, etc.) and admin files were checked against MoH criteria and some residents, relatives and staff were interviewed. Still very much a paper based exercise, rather than one concentrated on the actual delivery of care as we understood would be the case.
To cut a long story short, everything went well and the auditor's report concluded that Glenbrook Rest Home had fully attained all criteria!
Obviously we were over the moon with this result and owe thanks to all our staff for achieving this. Without our dedicated and caring staff team this result would have been impossible.
So you see, there is good news in the aged care sector, but will this be reported in the media?
This year we were due for a full audit on June 28. Two auditors came to site for the day. As usual, the experience was pleasant and friendly. Don't understand why some people get uptight and nervous about it. They quite thoroughly went through some files to check that things were recorded correctly and residents got the care they need.
Everything was up to scratch ('perfect' as we call it), but they found two small partial attainments (PAs). Both had to do with the fact that some residents had not signed their admission agreement on the actual day of admission. In a typical non-sensical, bureaucratic way, we are told off for not having the contract signed on the day of admission, but at the same time the bureaucrats themsleves admit this is not always possible! So we're doomed if we do, and we're doomed if we don't.
(Signing on admission day is not always possible because some residents move into the rest home the very same day that they first contacted us. As we are obliged to give the resident and their family the opportunity to take away the agreement to read through properly, there is just no chance to sign that day. We have pointed this out to MoH and are waiting for a reply. Watch this space..... a standard clause has been added to the resident admission agreement saying that 'the agreement has not been signed on the day of admission because the resident/relatives wanted more time to read through it'. That's all it took.)
Other than that, everything was found to be good. The auditors commented on the accurate and transparant resident record keeping. Well done Sharon. They had also received very positive feedback from residents and relatives on the meals that were served and on the homely and family-like atmosphere. Well done all of us!
In short, again we have been very satisfied with the audit and our dedication and long hours have not been in vain. In the meantime we're still waiting for the Minister of Health to properly fund smaller rest homes, so we can pay staff (and management) the pay they deserve for their work in the morning, evening, night, weekdays and weekends, 365 days per year!
Thank you to all staff.
This time we were due for a so called 'unannounced' spot audit in the period three months either side of 25 Feb 2013. The auditor turned up on Mar 6. Again, the auditor was pleasant, reasonable and practical. We passed everything. What is there to add?
Thank you to the auditor, staff and residents. Also a big thank you and congratulations to RN Sharon. She is the 'heart' of Glenbrook Rest Home. Her drive and compassion to do the best she can shows through the care that our residents receive. She goes the extra mile and makes our home a real home.
A full audit took place in July. Two auditors. Again, all went well and the auditors were pleasant and realistic. Two minor Partial Attainments (PAs) were found. One to do with Standing Orders, the other with oncharging to private paying residents.
Standing Orders are guidelines regarding medications in stock. Having some medicatons in stock is useful because it shortens the time between a GP prescribing medication and the resident getting the medicaton (we don't have to wait for medications to arrive from the pharmacy). The rules around stock medications are very complicated and it is a lot easier to not have any medications in stock. So we did away with medications in stock alltogether, rather than be burdened with the need to have policies and all the associated paperwork and red tape to comply with.
Oncharging to private payers certain services was allowed a few years ago and it had always been a clause in our admission agreement. No auditor had ever commented on it. Nothing was mentioned during the actual audit, but a few weeks later Counties Manukau District Health Board (CMDHB) asked a Ministry of Health staff to do an audit of our oncharging. It was found we had been overcharging and were given the opportunity to comment on the draft report before submission to CMDHB. A letter was sent and attached to the final report to CMDHB. The latter totally ignored it. It didn't even acknowledge it! Some time later an email arrived with CMDHB 'requesting confirmation of reimbursement' (ordinary people would say we had to pay it back). Another letter was sent to CMDHB, with copies to CMDHB management members and MOH, pointing out the difficulties a small rural rest home like ours faces because of chronic underfunding (this was the reason why we were forced to oncharge in the first place). Would they work evenings/nights, weekends, public holidays, etc. for barely more than the minimum wage? The only response so far is that 'my comments have been passed on to the Programme Director Health of Older People'. In the meantime we have stopped oncharging and changed our admission agreement accordingly.
In March 2015 a follow up visit by a CMDHB staff took place to confirm we had corrected our two PAs. All was found to be okay.
Despite the two minor PAs, Glenbrook Rest Home received a four year certification period instead of the usual three years. This confirmes the excellent care and service it provides.