Published Decision (SA and RA) s1

Forest View Residential Care Facility

RACS ID: 5444 Approved provider: Queensland Health Home address: 80 Scott Street WONDAI QLD 4606

Following an audit we decided that this home met 44 of the 44 expected outcomes of the Accreditation Standards and would be accredited for three years until 05 July 2020. We made our decision on 11 May 2017. The audit was conducted on 11 April 2017 to 12 April 2017. The assessment team’s report is attached.

We will continue to monitor the performance of the home including through unannounced visits. 1. Most recent decision concerning performance against the Accreditation Standards Standard 1: Management systems, staffing and organisational development Principle: Within the philosophy and level of care offered in the residential care service, management systems are responsive to the needs of care recipients, their representatives, staff and stakeholders, and the changing environment in which the service operates. 1.1 Continuous improvement Met 1.2 Regulatory compliance Met 1.3 Education and staff development Met 1.4 Comments and complaints Met 1.5 Planning and leadership Met 1.6 Human resource management Met 1.7 Inventory and equipment Met 1.8 Information systems Met 1.9 External services Met Standard 2: Health and personal care Principles: Care recipients’ physical and mental health will be promoted and achieved at the optimum level in partnership between each care recipient (or his or her representative) and the health care team. 2.1 Continuous improvement Met 2.2 Regulatory compliance Met 2.3 Education and staff development Met 2.4 Clinical care Met 2.5 Specialised nursing care needs Met 2.6 Other health and related services Met 2.7 Medication management Met 2.8 Pain management Met 2.9 Palliative care Met 2.10 Nutrition and hydration Met 2.11 Skin care Met 2.12 Continence management Met 2.13 Behavioural management Met 2.14 Mobility, dexterity and rehabilitation Met 2.15 Oral and dental care Met 2.16 Sensory loss Met 2.17 Sleep Met

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 2 Standard 3: Care recipient lifestyle Principle: Care recipients retain their personal, civic, legal and consumer rights, and are assisted to achieve active control of their own lives within the residential care services and in the community. 3.1 Continuous improvement Met 3.2 Regulatory compliance Met 3.3 Education and staff development Met 3.4 Emotional Support Met 3.5 Independence Met 3.6 Privacy and dignity Met 3.7 Leisure interests and activities Met 3.8 Cultural and spiritual life Met 3.9 Choice and decision-making Met 3.10 Care recipient security of tenure and responsibilities Met Standard 4: Physical Principle: Care recipients live in a safe and comfortable environment that ensures the quality of life and welfare of care recipients, staff and visitors 4.1 Continuous improvement Met 4.2 Regulatory compliance Met 4.3 Education and staff development Met 4.4 Living environment Met 4.5 Occupational health and safety Met 4.6 Fire, security and other emergencies Met 4.7 Infection control Met 4.8 Catering, cleaning and laundry services Met

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 3 Audit Report

Name of home: Forest View Residential Care Facility RACS ID: 5444 Approved provider: Queensland Health 2. Introduction This is the report of a Re-accreditation Audit from 11 April 2017 to 12 April 2017 submitted to the Quality Agency. Accredited residential aged care homes receive Australian Government subsidies to provide quality care and services to care recipients in accordance with the Accreditation Standards. To remain accredited and continue to receive the subsidy, each home must demonstrate that it meets the Standards. There are four Standards covering management systems, health and personal care, care recipient lifestyle, and the physical environment and there are 44 expected outcomes such as human resource management, clinical care, medication management, privacy and dignity, leisure interests, cultural and spiritual life, choice and decision-making and the living environment. Each home applies for re-accreditation before its accreditation period expires and an assessment team visits the home to conduct an audit. The team assesses the quality of care and services at the home and reports its findings about whether the home meets or does not meet the Standards. The Quality Agency then decides whether the home has met the Standards and whether to re-accredit or not to re-accredit the home. During a home’s period of accreditation there may be a review audit where an assessment team visits the home to reassess the quality of care and services and reports its findings about whether the home meets or does not meet the Standards. 3. Assessment team’s findings regarding performance against the Accreditation Standards The information obtained through the audit of the home indicates the home meets: 44 expected outcomes

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 4 4. Scope of this document An assessment team appointed by the Quality Agency conducted the Re-accreditation Audit from 11 April 2017 to 12 April 2017. The audit was conducted in accordance with the Quality Agency Principles 2013 and the Accountability Principles 2014. The assessment team consisted of two registered aged care quality assessors. The audit was against the Accreditation Standards as set out in the Quality of Care Principles 2014. 5. Details of home Total number of allocated places: 46 Number of care recipients during audit: 46 Number of care recipients receiving high care during audit: 46 Special needs catered for: Care recipients requiring a secure environment

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 5 6. Audit trail The assessment team spent two days on site and gathered information from the following: Interviews

Position title Number

Director of Nursing 1

Nurse Unit Manager 1

Clinical Nurse Consultant 1

Registered staff 3

Care staff 5

Care recipients/representatives 10

Volunteers 2

Hospitality staff 5

Recreation staff 2

Maintenance staff 1

Operational staff 2

Medical Officer 1

Pharmacy Assistant 1

Infection Control Practitioner 1

Nurse Educator 1

Occupational Health and Safety staff 2

Administration Officer 2

Sampled documents

Document type Number

Care recipients’ files 10

Medication charts 15

Other documents reviewed The team also reviewed: Activities planner – group and individual Approval for use of protective assistance

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 6 Bowel management chart Care recipients’ information handbook Caring together assessment Catering event request Catheter output/record Clinical assessments Colostomy/ileostomy form Communications book Controlled drug register Documentation schedule Drug fridge and room temperature chart Electoral roll list Evacuation mobility list External food safety audit report Fluid restriction input plan Food and fluid intake chart Food safety plan Functional mobility risk assessment form Handover sheet Incident report Individual continence maintenance schedule Internal audit/self-assessment Mandatory education register Mandatory reporting register Memoranda Minutes of meetings Monthly incident and risk management summary Orientation package Person of the day checklist Pet care plans Police certificate records Post fall clinical pathway Pre-admission pack Preventative and corrective maintenance documentation Quality improvement plan Recreation officer report – group activity evaluation Religion report

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 7 Resident agreement Residential aged care and accommodation handbook Restraint authorisations Roster Staff education records Staff hygiene information and agreement Statement of choices Therapeutic diet plan Vision, purpose and values statement Volunteer application Volunteers list Weight monitoring chart Work, health and safety checklist Wound assessment and management plan Observations The team observed the following: Activities in progress Administration of medication Cleaning in progress Equipment and supply storage areas Evacuation signs and diagrams Feedback box Handover processes Interactions between staff and care recipients Internal and external living environment Meal and beverage service Medication storage Personal protective equipment Short group observation Spill kits Storage of medications

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 8 7. Assessment information This section covers information about the home’s performance against each of the expected outcomes of the Accreditation Standards. Standard 1 – Management systems, staffing and organisational development Principle: Within the philosophy and level of care offered in the residential care services, management systems are responsive to the needs of care recipients, their representatives, staff and stakeholders, and the changing environment in which the service operates. 1.1 Continuous improvement This expected outcome requires that “the organisation actively pursues continuous improvement”. Team's findings The home meets this expected outcome The continuous improvement program includes processes for identifying areas for improvement, implementing change, monitoring and evaluating the effectiveness of improvements. Feedback is sought from care recipients, representatives, staff and other stakeholders to direct improvement activities. Improvement activities are documented on the plan for continuous improvement. Management uses a range of monitoring processes such as audits and quality indicators to monitor the performance of the home's quality management systems. Outcomes are evaluated for effectiveness and ongoing monitoring of new processes occurs. Care recipients, representatives, staff and other personnel are provided with feedback about improvements. During this accreditation period the organisation has implemented initiatives to improve the quality of care and services it provides. Recent examples of improvements in Standard 1 Management systems, staffing and organisational development are:  In response to feedback from staff, management identified an opportunity to improve orientation processes for staff. An orientation manual that provides a reference guide for staff has been developed. This is a new initiative and yet to be fully evaluated.  Following feedback from staff, management identified an opportunity to improve communication in relation to allied health visits. An allied health spreadsheet has been developed that identifies care recipients visited, by whom and when. Feedback from staff has been positive stating it has improved referral processes to allied health professionals.

1.2 Regulatory compliance This expected outcome requires that “the organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards and guidelines”. Team's findings The home meets this expected outcome The home has a system to identify relevant legislation, regulatory requirements and guidelines, and for monitoring these in relation to the Accreditation Standards. The organisation's management has established links with external organisations to ensure they are informed about changes to regulatory requirements. Where changes occur, the organisation takes action to update policies and procedures and communicate the changes to care recipients, their representatives and staff as appropriate. A range of systems and processes have been established by management to ensure compliance with regulatory

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 9 requirements. Staff have an awareness of legislation, regulatory requirements, professional standards and guidelines relevant to their roles. Relevant to Standard 1: Management are aware of the regulatory responsibilities in relation to police certificates and the requirement to provide advice to care recipients and their representatives about re-accreditation site audits; there are processes to ensure these responsibilities are met. 1.3 Education and staff development This expected outcome requires that “management and staff have appropriate knowledge and skills to perform their roles effectively”. Team's findings The home meets this expected outcome The home's processes support the recruitment of staff with the required knowledge and skills to perform their roles. New staff participate in an orientation program that provides them with information about the organisation, key policies and procedures and equips them with mandatory skills for their role. Staff are scheduled to attend regular mandatory training; attendance is monitored and a process available to address non-attendance. The effectiveness of the education program is monitored through attendance records, evaluation records and observation of staff practice. Care recipients and representatives are satisfied staff have the knowledge and skills to perform their roles and staff are satisfied with the education and training provided. 1.4 Comments and complaints This expected outcome requires that "each care recipient (or his or her representative) and other interested parties have access to internal and external complaints mechanisms". Team's findings The home meets this expected outcome There are processes to ensure care recipients, their representatives and others are provided with information about how to access complaint mechanisms. Care recipients and others are supported to access these mechanisms. Facilities are available to enable the submission of confidential complaints and ensure privacy of those using complaints mechanisms. Complaints processes link with the home's continuous improvement system and where appropriate, complaints trigger reviews of and changes to the home's procedures and practices. The effectiveness of the comments and complaints system is monitored and evaluated. Results show complaints are considered and feedback is provided to complainants if requested. Management and staff have an understanding of the complaints process and how they can assist care recipients and representatives with access. Care recipients, their representatives and other interested people have an awareness of the complaints mechanisms available to them and are satisfied they can access these without fear of reprisal. 1.5 Planning and Leadership This expected outcome requires that "the organisation has documented the residential care service’s vision, values, philosophy, objectives and commitment to quality throughout the service". Team's findings The home meets this expected outcome The organisation has documented the home's vision, purpose, values and commitment to quality. This information is communicated to care recipients, representatives, staff and others through a range of documents.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 10 1.6 Human resource management This expected outcome requires that "there are appropriately skilled and qualified staff sufficient to ensure that services are delivered in accordance with these standards and the residential care service’s philosophy and objectives". Team's findings The home meets this expected outcome There are systems and processes to ensure there are sufficient skilled and qualified staff to deliver services that meet the Accreditation Standards and the home's philosophy and objectives. Recruitment, selection and induction processes ensure staff have the required knowledge and skills to deliver services. Staffing levels and skill mix are reviewed in response to changes in care recipients' needs and there are processes to address planned and unplanned leave. The home's monitoring, human resource and feedback processes identify opportunities for improvement in relation to human resource management. Staff are satisfied they have sufficient time to complete their work and meet care recipients' needs. Care recipients and representatives are satisfied with the availability of skilled and qualified staff and the quality of care and services provided. 1.7 Inventory and equipment This expected outcome requires that "stocks of appropriate goods and equipment for quality service delivery are available". Team's findings The home meets this expected outcome The home has processes to monitor stock levels, order goods and maintain equipment to ensure delivery of quality services. Goods and equipment are securely stored and, where appropriate, stock rotation occurs. Preventative maintenance and cleaning schedules ensure equipment is monitored for operation and safety. Faulty equipment is identified, removed from service and replaced or repaired as required. The home purchases equipment to meet care recipients' needs and maintains appropriate stocks of required supplies. Staff receive training in the safe use and storage of goods and equipment. Staff, care recipients and representatives are satisfied with the supply and quality of goods and equipment available at the home. 1.8 Information systems This expected outcome requires that "effective information management systems are in place". Team's findings The home meets this expected outcome The home has systems to provide all stakeholders with access to current and accurate information. Management and staff have access to information that assists them in providing care and services. Electronic and hard copy information is stored securely and processes are in place for backup, archive and destruction of obsolete records, in keeping with legislative requirements. Key information is collected, analysed, revised and updated on an ongoing basis. Data obtained through information management systems is used to identify opportunities for improvement. The home regularly reviews its information management systems to ensure they are effective. Staff are satisfied they have access to current and accurate information. Care recipients and representatives are satisfied the information provided is appropriate to their needs, and supports them in their decision-making.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 11 1.9 External services This expected outcome requires that "all externally sourced services are provided in a way that meets the residential care service’s needs and service quality goals". Team's findings The home meets this expected outcome The home has mechanisms to identify external service needs and quality goals. The home's expectations in relation to service and quality is specified and communicated to the external providers. The home has agreements with external service providers which outline minimum performance, staffing and regulatory requirements. There are processes to review the quality of external services provided and, where appropriate, action is taken to ensure the needs of care recipients and the home are met. Staff are able to provide feedback on external service providers. Care recipients, representatives and staff are satisfied with the quality of externally sources services.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 12 Standard 2 – Health and personal care Principle: Care recipients’ physical and mental health will be promoted and achieved at the optimum level in partnership between each care recipient (or his or her representative) and the health care team. 2.1 Continuous improvement This expected outcome requires that “the organisation actively pursues continuous improvement”. Team's findings The home meets this expected outcome The continuous improvement program includes processes for identifying areas for improvement, implementing change, monitoring and evaluating the effectiveness of improvements. Feedback is sought from care recipients, representatives, staff and other stakeholders to direct improvement activities. Improvement activities are documented on the plan for continuous improvement. Management uses a range of monitoring processes such as audits and quality indicators to monitor the performance of the home's quality management systems. Outcomes are evaluated for effectiveness and ongoing monitoring of new processes occurs. Care recipients, representatives, staff and other personnel are provided with feedback about improvements. During this accreditation period the organisation has implemented initiatives to improve the quality of care and services it provides. Recent examples of improvements in Standard 2 Health and personal care are:  In response to an internal audit, management identified an opportunity to improve care recipients’ skin integrity. Input from a continence aid advisor was sought and a recommended skin moisturiser has been introduced. Staff education was provided and management state there has been a reduction in groin rashes.  Clinical staff identified an opportunity to improve communication of pressure area care. A pressure area care column has been added to the handover sheet informing staff of care recipients at risk. The handover sheet acts as a prompt for care staff and management state there has been a reduction in pressure areas.  Following observation of care recipients, management identified an opportunity to improve access to mobility equipment. Physiotherapy balance bars have been relocated from the therapy centre to an area that is easily accessible to care recipients. We observed care recipients using the balance bars for mobility and exercise regimes.

2.2 Regulatory compliance This expected outcome requires that “the organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards and guidelines about health and personal care”. Team's findings The home meets this expected outcome Refer to Expected outcome 1.2 Regulatory compliance for information about the home's systems to identify and ensure compliance with relevant regulatory requirements. Relevant to Standard 2, management are aware of the regulatory responsibilities in relation to specified care and services, professional registrations and medication management. There are systems to ensure these responsibilities are met. 2.3 Education and staff development

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 13 This expected outcome requires that “management and staff have appropriate knowledge and skills to perform their roles effectively”. Team's findings The home meets this expected outcome The home's processes support the recruitment of staff with the required knowledge and skills to perform their roles. New staff participate in an orientation program that provides them with information about the organisation, key policies and procedures and equips them with mandatory skills for their role. Staff are scheduled to attend regular mandatory training; attendance is monitored and a process available to address non-attendance. The effectiveness of the education program is monitored through attendance records, evaluation records and observation of staff practice. Care recipients and representatives are satisfied staff have the knowledge and skills to perform their roles and staff are satisfied with the education and training provided. 2.4 Clinical care This expected outcome requires that “care recipients receive appropriate clinical care”. Team’s findings The home meets this expected outcome Care recipients’ clinical needs are assessed on entry to the home by the Clinical Nurse Consultant and registered staff through interviews with care recipients and their representatives utilising application information and discharge summaries as provided. Interim care plans are established which guide staff until the completion of assessment data which guides staff in creating care planning interventions and the completion of a comprehensive care plan. Care plans are reviewed every three months and as required; reassessment occurs if indicated; changes are actioned, and care plans are amended as required. Care staff are knowledgeable of individualised care recipient requirements, and their knowledge is consistent with care plans. Information relating to care recipients’ health status is discussed at shift handover and recorded in progress notes and handover reports. Medical officers support the home with regular visitation and on-call arrangements. Incident reports are created following interruptions to the delivery of clinical care. Incident reports are reviewed by management and remain active until resolution. Care recipients and representatives are satisfied with the clinical care provided by staff. 2.5 Specialised nursing care needs This expected outcome requires that “care recipients’ specialised nursing care needs are identified and met by appropriately qualified nursing staff”. Team’s findings The home meets this expected outcome The home has systems and processes to support the specialised nursing care needs of care recipients. The home is currently providing, and has equipment and skills to support care needs such as diabetes management, catheter care, stoma therapy, anti-coagulant therapy, wound management, pain management and palliative care. Registered nurses assess the initial and ongoing specialised nursing care needs, and establish care recipients’ preferences in consultation with medical officers. Care plans and management plans are available and/or developed to guide staff practice; care guidelines support specific care needs and interventions are evaluated regularly or as required. Registered nurses are onsite 24 hours a day, and oversee and assess specific care requirements. Care recipients and representatives are satisfied with the quality of care provided at the home and the support received with specialised care needs.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 14 2.6 Other health and related services This expected outcome requires that “care recipients are referred to appropriate health specialists in accordance with the care recipient’s needs and preferences”. Team’s findings The home meets this expected outcome The home has processes to support referral to other health and related services where care recipients’ health needs dictate. Care recipients’ needs and preferences are assessed on entry to the home and on an ongoing basis. Care recipients are supported and encouraged to access other health professionals and health services including podiatry, dietetics, audiology, occupational therapy, physiotherapy and speech pathology. Most services are provided on site through the use of preferred allied health services, and assistance for care recipients to attend external appointments is facilitated when necessary. Directives from allied health professionals are followed and understood by staff. Care recipients and representatives are satisfied with the range of and access to allied health specialists. 2.7 Medication management This expected outcome requires that “care recipients’ medication is managed safely and correctly”. Team’s findings The home meets this expected outcome Care recipients’ medication needs are assessed on entry to the home and on an ongoing basis. Medications are managed using original packaging delivered by the home’s preferred pharmacy. Registered staff administer medications and complete annual competencies. Policies and procedures guide staff in ensuring care recipients’ medication is managed safely and correctly. Medications are stored securely and records of controlled medications are maintained. Those medications required to be stored at specific temperatures are stored within refrigerated confines and are monitored for appropriate storage temperatures. ‘As required’ medication is documented and monitored for its effectiveness. Care recipients who prefer to manage their own medication are assessed in relation to their competency. Incident forms capture information related to medication errors and staff or pharmacy practices are reviewed following incidents. Medication charts contain information to guide staff in the administration or assistance required when administering medication to care recipients. Care recipients indicate they receive their medication in a timely manner and are satisfied with the support they receive in relation to medications. 2.8 Pain management This expected outcome requires that “all care recipients are as free as possible from pain”. Team’s findings The home meets this expected outcome The pain management needs of care recipients are identified through initial assessments on entry to the home using focus tools with provisions for non-verbal assessments as required. Pain strategies are implemented as required and include medication, liniment rubs, massages, heat packs, repositioning and pressure-relieving devices. Medication measures include regular prescribed oral pain relief and patches. The use of pain relief is monitored for effectiveness and ‘as required’ pain relief is recorded and monitored for frequency of use. Pain management strategies are reviewed regularly, and as required, to ensure the interventions for pain are current. Staff have access to information relating to the pain management requirements of care recipients. Care recipients are as free from pain as possible and are satisfied with the care they receive to minimise pain.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 15 2.9 Palliative care This expected outcome requires that “the comfort and dignity of terminally ill care recipients is maintained”. Team’s findings The home meets this expected outcome Palliative care strategies and wishes are discussed with care recipients/representatives on entry to the home or at a time, which is suitable. Information such as enduring power of attorney and advance health directives are located in the care recipient records if required. The home is supported by their own palliative care resources, including syringe drivers and pain relief medication. Staff have access to other palliative care resources such as mouth care products and specialised bedding to ensure appropriate care provision. Representatives are encouraged to stay at the home with their loved one and are supported with meals and bedding. Staff are aware of the care needs and measures to provide comfort and dignity for terminally ill care recipients. 2.10 Nutrition and hydration This expected outcome requires that “care recipients receive adequate nourishment and hydration”. Team’s findings The home meets this expected outcome Care recipients’ dietary needs, allergies, likes and dislikes are identified on entry to the home and on an ongoing basis. Nutrition and hydration requirements, special diets and preferences are reflected in care plans and dietary forms to guide staff practice. Care recipients’ dietary requirements are reviewed regularly and as required. Catering staff are alerted to changes in diets and fluid requirements. Care recipients are weighed in accordance with their individual requirements and changes in weight and/or changes in oral intake are monitored by registered staff to support changes in diet, supplements and/or referral to the Dietitian and Speech Pathologist if required. Strategies implemented to assist care recipients to maintain adequate nourishment and hydration include assistance with meals, fortification of meals and dietary supplements. Care recipients and representatives are satisfied with actions taken to ensure care recipients receive adequate nourishment and hydration. 2.11 Skin care This expected outcome requires that “care recipients’ skin integrity is consistent with their general health”. Team’s findings The home meets this expected outcome Care recipients’ skin integrity is assessed on entry to the home and planned interventions are included in the care recipients’ care plans to guide staff practice. The potential for compromised skin integrity is also assessed and preventative strategies implemented as appropriate, including moisturisers, pressure-relieving devices and assistance with personal hygiene. Skin care needs are reviewed during hygiene routines, reassessed regularly and changes communicated in wound documentation, care plans, handover sheets and progress notes. Wound care is managed by registered staff with scheduled weekly wound reviews also completed by registered nurses. Staff are guided by wound care pathways, which reflect the care recipients’ current wound care needs. Staff have an understanding of factors associated with risks to care recipients’ skin integrity. The incidence of injury/skin tears is captured on incident reports and interventions are implemented as appropriate. The home has sufficient supplies of wound and skin care products to ensure effective skin care

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 16 management when required. Care recipients are satisfied with the management of their skin integrity. 2.12 Continence management This expected outcome requires that “care recipients’ continence is managed effectively”. Team’s findings The home meets this expected outcome Care recipients’ continence needs are assessed on entry to the home and on an ongoing basis. Care plans and continence profiles direct staff practice and ensure individual care recipients’ preferences are met. Staff have an understanding of continence promotion strategies such as the use of aids and toileting programs. Staff monitor and record urinary and bowel patterns and registered staff are alerted to alterations in care recipients’ normal continence levels. Individualised bowel management programs are developed and include medication and other natural methods. Care recipients are satisfied with the assistance by staff to maintain their continence. 2.13 Behavioural management This expected outcome requires that “the needs of care recipients with challenging behaviours are managed effectively”. Team’s findings The home meets this expected outcome Care recipients are assessed on entry to the home and actual or potential indicators for challenging behaviours are identified. Staff monitor and chart challenging behaviour to enable assessment by the registered staff and the development of behaviour management plans that identify risks, triggers and strategies for staff to trial to manage challenging behaviours. Staff are knowledgeable of individual needs and risks. Staff support care recipients in maintaining their abilities and interests as well as providing distraction and one- on-one support when they are unsettled. The effectiveness of strategies used by various staff members to assist care recipients with challenging behaviours is communicated in progress notes and discussed at handover. Authorisation is sought prior to use of environmental, physical or chemical restraint and this requirement is reviewed regularly. Care recipients and representatives are satisfied with the way challenging behaviours are managed. 2.14 Mobility, dexterity and rehabilitation This expected outcome requires that “optimum levels of mobility and dexterity are achieved for all care recipients”. Team’s findings The home meets this expected outcome Care recipients’ mobility, transfer and dexterity needs and falls risks are identified on entry to the home. Referral to physiotherapy services occurs following entry to the home and when there are identified issues relating to mobility. Care plans are developed and reviewed regularly and as required. Staff provide assistance to care recipients with range of movement activities during hygiene cares and through the promotion of regular exercise. Mobility aids such as hoists, wheelchairs and wheeled walkers are provided if required. Incident forms are utilised to record the incidence of falls and actions are taken to reduce the risk of further falls or injury, for example the provision of falls prevention helmets and low beds. Staff are provided with mandatory training in manual handling techniques. Care recipients are satisfied with the assistance provided to maintain mobility and maximise independence. 2.15 Oral and dental care This expected outcome requires that “care recipients’ oral and dental health is maintained”.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 17 Team’s findings The home meets this expected outcome Care recipients’ oral and dental care needs are assessed on entry to the home and care strategies are developed including the consideration for preferences. The level of assistance required maintaining oral and dental hygiene is determined and this information is included in care plans to guide staff practice. The effectiveness of care plans is reviewed regularly and as care needs change. Monthly oral care assessments are completed as part of the ‘person of the day’ schedule. Dental services are provided at the home via regular visits from a dental hygienist and assistance is provided to access or the care recipients’ preferred dental provider if required. Resources such as mouth care products are utilised to meet care recipients’ oral hygiene needs. Care recipients and representatives are satisfied with the assistance given to care recipients by staff to maintain oral and dental health. 2.16 Sensory loss This expected outcome requires that “care recipients’ sensory losses are identified and managed effectively”. Team’s findings The home meets this expected outcome Care recipients’ care needs in relation to senses and communication are assessed on entry to the home, reassessed regularly and when care needs change. Care plans are developed to guide staff practice and strategies address identified needs and personal preferences, including reference to the use of assistive devices. Care recipients identified with impaired sensory function have specific care planning guidelines to assist staff in their daily care, including hearing aid battery changes and the cleaning of spectacles and hearing aids. The lifestyle program includes activities to stimulate care recipients’ senses such as cooking and musical activities. Audiology and optometry specialists are accessed as required to identify and address identified concerns and/or provide ongoing management. The environment at the home supports the needs of care recipients with sensory loss by the use of specific storage areas for large equipment and clear pathways. Care recipients and representatives are satisfied with the care and support offered care recipients to minimise the impact of any sensory loss. 2.17 Sleep This expected outcome requires that “care recipients are able to achieve natural sleep patterns”. Team’s findings The home meets this expected outcome Care recipients’ preferred sleep and rest patterns are identified on entry to the home. Focus tools are utilised by staff to monitor sleep patterns and triggers for sleep disturbances such as pain or toileting needs are identified. Staff at the home maintain a quiet environment to assist care recipients to settle and remain asleep. Staff have access to snacks for care recipients who require additional nourishment overnight. Medical officers are consulted if interventions are considered to be ineffective. Care recipients are satisfied with the interventions by staff to assist them to achieve their desired sleep and rest patterns.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 18 Standard 3 – Care recipient lifestyle Principle: Care recipients retain their personal, civic, legal and consumer rights, and are assisted to achieve control of their own lives within the residential care service and in the community. 3.1 Continuous improvement This expected outcome requires that “the organisation actively pursues continuous improvement”. Team's findings The home meets this expected outcome The continuous improvement program includes processes for identifying areas for improvement, implementing change, monitoring and evaluating the effectiveness of improvements. Feedback is sought from care recipients, representatives, staff and other stakeholders to direct improvement activities. Improvement activities are documented on the plan for continuous improvement. Management uses a range of monitoring processes such as audits and quality indicators to monitor the performance of the home's quality management systems. Outcomes are evaluated for effectiveness and ongoing monitoring of new processes occurs. Care recipients, representatives, staff and other personnel are provided with feedback about improvements. During this accreditation period the organisation has implemented initiatives to improve the quality of care and services it provides. Recent examples of improvements in Standard 3 Care recipient lifestyle are:  Following feedback from care recipients, management identified an opportunity to improve the communication of scheduled lifestyle activities. An area of wall has been painted in a contrasting colour in two areas of the home. The activities calendar which is printed on white paper is posted on these contrasting walls. Feedback from care recipients has been positive stating the calendar is easier to read.  In response to a written complaint from representatives, management identified an opportunity to improve the enjoyment of church services in the home. Concerns had been raised regarding noise from the nearby servery and staff interaction. The church service has been moved to an area further away from the servery and staff have been counselled. Feedback from the representatives has been positive stating the new arrangement is working well.

3.2 Regulatory compliance This expected outcome requires that “the organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards and guidelines, about care recipient lifestyle”. Team's findings The home meets this expected outcome Refer to Expected outcome 1.2 Regulatory compliance for information about the home's systems to identify and ensure compliance with relevant regulatory requirements. Relevant to Standard 3, management are aware of the regulatory responsibilities in relation to compulsory reporting, user rights, security of tenure and care recipient agreements. There are systems to ensure these responsibilities are met. 3.3 Education and staff development This expected outcome requires that “management and staff have appropriate knowledge and skills to perform their roles effectively”.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 19 Team's findings The home meets this expected outcome The home's processes support the recruitment of staff with the required knowledge and skills to perform their roles. New staff participate in an orientation program that provides them with information about the organisation, key policies and procedures and equips them with mandatory skills for their role. Staff are scheduled to attend regular mandatory training; attendance is monitored and a process available to address non-attendance. The effectiveness of the education program is monitored through attendance records, evaluation records and observation of staff practice. Care recipients and representatives are satisfied staff have the knowledge and skills to perform their roles and staff are satisfied with the education and training provided. 3.4 Emotional support This expected outcome requires that "each care recipient receives support in adjusting to life in the new environment and on an ongoing basis". Team’s findings The home meets this expected outcome The home has processes to ensure care recipients are supported in adjusting to their new home and on an ongoing basis. Care recipients are provided with information about available services prior to entry as well as orientation to the home and their room on arrival. Care plans are developed with strategies to assist care recipients emotionally such as one-on-one visits and activities to assist with adjustment to the home. The maintenance of social, cultural and community links is encouraged by the home as is the inclusion of items of personal significance in rooms. Ongoing emotional support needs are monitored through staff interactions with care recipients, care plan reviews and handover processes. Care recipients and representatives are satisfied with the support received from staff during the settling in period and with the ongoing support provided by staff and management. 3.5 Independence This expected outcome requires that "care recipients are assisted to achieve maximum independence, maintain friendships and participate in the life of the community within and outside the residential care service". Team’s findings The home meets this expected outcome Care recipients are encouraged and supported to maintain their independence at a level that is appropriate to their individual needs and abilities. Assessment processes identify previous interests and lifestyle as well as their current interests and abilities. This information assists with the development of care plans that maximise individual opportunities to maintain independence. Transport is provided to assist with shopping requirements and volunteer services manage a shopping trolley at the home. The civil rights of care recipients are respected and voting arrangements are provided as required. Care recipients are assisted and encouraged to maintain friendships and participate in the life of the community within and outside the home. Care recipients are encouraged to use aids such as spectacles and walking frames to maintain their independence. Care recipients are satisfied with the support and encouragement given by staff to enable them to remain as independent as possible. 3.6 Privacy and dignity This expected outcome requires that "each care recipient’s right to privacy, dignity and confidentiality is recognised and respected".

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 20 Team’s findings The home meets this expected outcome The home maintains a supportive environment that protects care recipients’ privacy and dignity. Entry processes provide care recipients with information about their rights, including their right to privacy; staff are informed of their responsibility to respect care recipients’ privacy and dignity and to maintain confidentiality regarding aspects of care requirements and personal information. Established administrative processes protect care recipients’ personal information. Staff are knowledgeable and demonstrate respect for care recipients’ privacy and dignity and individual preferences while providing care and services. Orientation processes ensure all staff and volunteers sign code of conduct statements. Care recipients are satisfied staff are respectful of their privacy and dignity when caring for them. 3.7 Leisure interests and activities This expected outcome requires that "care recipients are encouraged and supported to participate in a wide range of interests and activities of interest to them". Team’s findings The home meets this expected outcome The home offers care recipients lifestyle options that incorporate a range of interests and activities. Social and nursing care assessments are completed for each care recipient, capturing information that assists with determining care recipients’ individual participation levels. The home offers one-on-one options for care recipients who choose not to be involved in group activities. Volunteers assist with both group activities and individual support. Group activities are designed around care recipients’ preferences and suggestions and are held in various areas of the home. Lifestyle staff state that bingo, bus trips, music and drum therapy and card games are popular lifestyle choices for the care recipients. Care recipient participation is monitored through entries in activity records and satisfaction is assessed through meeting forums and surveys and future activities are planned and discussed with care recipients. Care recipients are assisted to participate in activities of choice and are satisfied with the lifestyle options offered at the home. 3.8 Cultural and spiritual life This expected outcome requires that "individual interests, customs, beliefs and cultural and ethnic backgrounds are valued and fostered". Team’s findings The home meets this expected outcome Care recipients’ specific cultural and spiritual needs are identified through initial and ongoing assessment processes. Religious services are held regularly at the home and care recipients are assisted and encouraged to attend services as desired. Communion is offered and provided to care recipients. Celebrations are held to mark days of cultural and religious significance, with catering staff able to provide special meals on these occasions. Staff are aware of care recipients’ individual spiritual needs. Care recipients’ cultural and spiritual needs are monitored through care recipient/representative feedback and care plan review processes. Care recipients are satisfied their cultural and spiritual needs and preferences are respected and supported. 3.9 Choice and decision-making This expected outcome requires that "each care recipient (or his or her representative) participates in decisions about the services the care recipient receives, and is enabled to exercise choice and control over his or her lifestyle while not infringing on the rights of other people".

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 21 Team’s findings The home meets this expected outcome Care recipients are provided with opportunities to participate in decision making through processes relating to care planning and delivery and lifestyle choices. Care recipients and their representatives are encouraged to be actively involved in these activities. Care recipients’ choices are identified through initial and ongoing assessment processes, comments and complaints processes and daily contact between staff and care recipients. Staff respect and accommodate care recipients’ choices, encourage them to be involved in all aspects of clinical care and to attend/contribute to activities. Staff have access and information relating to the preferred decision maker for each care recipient. Opportunities for care recipients to exercise their decision-making rights are monitored through care plan evaluations and care recipient feedback. Care recipients are satisfied with choices offered in matters relating to the care and services they receive. 3.10 Care recipient security of tenure and responsibilities This expected outcome requires that "care recipients have secure tenure within the residential care service, and understand their rights and responsibilities". Team’s findings The home meets this expected outcome Management demonstrate care recipients have secure tenure within the home and understand their rights and responsibilities. On entry to the home care recipients are provided with information relating to their rights and responsibilities, feedback mechanisms and privacy and confidentiality. Accommodation agreements are offered to all care recipients and include details regarding security of tenure and care and services provided by the home. Care recipients and/or representatives are consulted where changes may require a move within the home or to another home. Staff are informed of care recipient rights through orientation and ongoing training and care recipient satisfaction is monitored through surveys and feedback. Care recipients are satisfied they have appropriate access to information regarding their rights and feel secure in their tenure.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 22 Standard 4 – Physical environment and safe systems Principle: Care recipients live in a safe and comfortable environment that ensures the quality of life and welfare of care recipients, staff and visitors. 4.1 Continuous improvement This expected outcome requires that “the organisation actively pursues continuous improvement”. Team's findings The home meets this expected outcome The continuous improvement program includes processes for identifying areas for improvement, implementing change, monitoring and evaluating the effectiveness of improvements. Feedback is sought from care recipients, representatives, staff and other stakeholders to direct improvement activities. Improvement activities are documented on the plan for continuous improvement. Management uses a range of monitoring processes such as audits and quality indicators to monitor the performance of the home's quality management systems. Outcomes are evaluated for effectiveness and ongoing monitoring of new processes occurs. Care recipients, representatives, staff and other personnel are provided with feedback about improvements. During this accreditation period the organisation has implemented initiatives to improve the quality of care and services it provides. Recent examples of improvements in Standard 4 Physical environment and safe systems are:  In response to an environmental audit, management identified an opportunity to improve cleaning processes in the home. Cleaning schedules were reviewed and actions discussed at meetings, resulting in an update of cleaning schedules. Staff stated the schedules are much easier to use and identify their cleaning tasks.  Following feedback from a care recipient survey, management identified an opportunity to improve the meal service for care recipients. The menu has been modified to include a greater variety of fresh cooked meals. Initial feedback from care recipients has been positive. This initiative is yet to be fully evaluated.

4.2 Regulatory compliance This expected outcome requires that “the organisation’s management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards and guidelines, about physical environment and safe systems”. Team's findings The home meets this expected outcome Refer to Expected outcome 1.2 Regulatory compliance for information about the home's systems to identify and ensure compliance with relevant regulatory requirements. Relevant to Standard 4, management are aware of the regulatory responsibilities in relation to work, health and safety, fire systems and food safety. There are systems to ensure these responsibilities are met. 4.3 Education and staff development This expected outcome requires that “management and staff have appropriate knowledge and skills to perform their roles effectively”. Team's findings The home meets this expected outcome

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 23 The home's processes support the recruitment of staff with the required knowledge and skills to perform their roles. New staff participate in an orientation program that provides them with information about the organisation, key policies and procedures and equips them with mandatory skills for their role. Staff are scheduled to attend regular mandatory training; attendance is monitored and a process available to address non-attendance. The effectiveness of the education program is monitored through attendance records, evaluation records and observation of staff practice. Care recipients and representatives are satisfied staff have the knowledge and skills to perform their roles and staff are satisfied with the education and training provided. 4.4 Living environment This expected outcome requires that "management of the residential care service is actively working to provide a safe and comfortable environment consistent with care recipients’ care needs". Team's findings The home meets this expected outcome The home's environment reflects the safety and comfort needs of care recipients, including comfortable temperatures, noise and light levels, sufficient and appropriate furniture and safe, easy access to internal and external areas. Environmental strategies are employed to minimise care recipient restraint. The safety and comfort of the living environment is assessed and monitored through feedback from meetings, surveys, incident and hazard reporting, audits and inspections. There are appropriate preventative and routine maintenance programs for buildings, furniture, equipment and fittings. Staff support a safe and comfortable environment through hazard, incident and maintenance reporting processes. Care recipients and representatives are satisfied the living environment is safe and comfortable. 4.5 Occupational health and safety This expected outcome requires that "management is actively working to provide a safe working environment that meets regulatory requirements". Team's findings The home meets this expected outcome There are processes to support the provision of a safe working environment, including policies and procedures, staff training, routine and preventative maintenance and incident and hazard reporting mechanisms. Opportunities for improvement in the occupational health and safety program are identified through audits, inspections, supervision of staff practice, and analysis of incident and hazard data. Sufficient goods and equipment are available to support staff in their work and minimise health and safety risks. Staff have an understanding of safe work practices and are provided with opportunities to have input to the home's workplace health and safety program. Staff were observed to carry out their work safely and are satisfied management is actively working to provide a safe working environment. 4.6 Fire, security and other emergencies This expected outcome requires that "management and staff are actively working to provide an environment and safe systems of work that minimise fire, security and emergency risks". Team's findings The home meets this expected outcome Policies and procedures relating to fire, security and other emergencies are documented and accessible to staff; this includes an emergency evacuation plan. Staff are provided with education and training about fire, security and other emergencies when they commence work at the home and on an ongoing basis. Emergency equipment is inspected and maintained

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 24 and the environment is monitored to minimise risks. Strategies to provide a safe environment include environmental audits and testing of electrical equipment. Staff have an understanding of their roles and responsibilities in the event of a fire, security breach or other emergency and there are routine security measures. Care recipients and representatives know what they should do on hearing an alarm and feel safe and secure in the home. 4.7 Infection control This expected outcome requires that there is "an effective infection control program". Team’s findings The home meets this expected outcome The home has an effective infection control program to identify and contain potential and actual sources of infection including in the event of an outbreak. The program includes a food safety program, a vaccination program for care recipients and staff and pest control measures. Mandatory infection control education is provided to all staff. Care recipients’ infection statistics are recorded and reviewed by the clinical team. Personal protective equipment is available and hand washing facilities, hand sanitisers, sharps’ containers and spill kits are accessible. Cleaning schedules and laundry practices are monitored to ensure infection control guidelines are followed and food is handled in accordance with the food safety program. Staff are aware of infection control measures, including the appropriate use of personal protective equipment, hand hygiene procedures and precautions to be taken in the event of an outbreak. 4.8 Catering, cleaning and laundry services This expected outcome requires that "hospitality services are provided in a way that enhances care recipients’ quality of life and the staff’s working environment". Team's findings The home meets this expected outcome The home identifies the care recipients' needs and preferences relating to hospitality services on entry to the home through assessment processes and consultation with the care recipient and their representatives. There are processes available that support care recipients to have input into the services provided and the manner of their provision. The home's monitoring processes identify opportunities for improvement in relation to the hospitality services provided; this includes feedback from care recipients and representatives and monitoring of staff practice. We observed the home to be clean and care recipients/representatives state they are satisfied with the standard of cleaning. Care recipients' personal clothing and flat linen are laundered off site. Hospitality staff have access to information about care recipient preferences and receive feedback about services provided. Staff are satisfied the hospitality services enhance the working environment. Care recipients and representatives are satisfied the hospitality services meet care recipients' needs.

Home name: Forest View Residential Care Facility Date/s of audit: 11 April 2017 to 12 April 2017 RACS ID: 5444 25