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The Barriers Preventing Aged Residential Care Facilities From Obtaining Full Compliance at Certification and Surveillance Audits

Abstract

New Zealand has an ageing population (Office for Senior Citizens, 2015); it is estimated that by 2026 there will be an additional 20,000 residents requiring residential care (Barback, 2016).

In New Zealand, a mechanism for monitoring the standard of services provided by Aged Residential Care (ARC) facilities is the certification process. In 2015 only 10% of South Island ARC facilities that underwent a Certification or Surveillance audit attained full compliance. There is limited published research available outlining the areas of non-conformance. Without that knowledge, specifically targeted support and guidance cannot be adequately provided to ARC facilities.

The aim of this research was to identify the barriers preventing South Island (SI) ARC facilities from achieving full compliance at Certification and Surveillance audits. A qualitative methodological approach based in the post positivist paradigm was used to analyse the non-conformances described in the SI ARC Facilities 2015 Certification and Surveillance audit reports, and undertake in-depth interviews with auditors to identify the barriers.

A thematic analysis of the non-conformances identified 23 themes. The four themes that occurred at the greatest frequency were: Quality Systems; Care Planning; Risk Assessments and Assessment Tools; and Medication Management.
 
A thematic analysis of the in-depth auditor interviews identified five themes: Facility manager and staff understanding and awareness of the Health and Disability Services Standards (HDSS) and the Age Related Residential Care (ARRC) agreement requirements; Nursing staff (including quality and turnover); Quality and Risk Management; Medication management; and Care planning.

Recommendations to eliminate these barriers include facilities becoming familiar with the contractual and legislative requirements; development of strategies to reduce staff turnover and aid recruitment; and the use of electronic medication management systems and the electronic InterRAI assessment is embraced by ARC providers.