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Organisational governance

25 October 2019

Regardless of the size of a provider or facility, good organisational governance with appropriate systems and practices must be in place to ensure sustainability, regulatory compliance, and above all, safe and quality care.

What is organisational governance and why is it important?

Strong organisational governance helps ensure a provider is sustainable, lawful, operates effectively, and has the interests of its residents and clients as its priority, in order to deliver a fully compliant aged care service that is person-centred and consumer-directed.
It generally involves a structure of management and directorship, such as a Board, who drive the direction of the organisation, whilst a hierarchy of management and staff are responsible for the operation of the organisation through processes, policies, reporting and communication lines.
Unlike for-profit providers, St Vincent’s Care Services is not reportable to shareholders and investors. We are reportable to the St Vincent’s Health Australia (SVHA) Board, the Trustees of Mary Aikenhead Ministries, and the federal Government.
We are also reportable to our residents, clients and their families, as without them, we simply would not exist, and our commitment to quality care is only achievable through solid, sustainable leadership and governance.
To ensure our organisational governance is effective, St Vincent’s Care Services facilities, services and staff need to follow our policies and procedures at all times. This means facilities and staff may sometimes be unable to change their services and actions if it would contravene our policies and procedures.
However, in the interests of person-centred care and resident choice and dignity, communication and consultation between the resident or client and staff and management must be open and effective, to try to find an appropriate solution.
Examples of when good governance influences good care:
• Changing policies, operating practices or organisational structure to best respond to the needs of residents and clients. E.g. St Vincent’s Care Services prepared for the new Aged Care Quality Standards by implementing a range of new and updated policies, regarding Consumer Dignity, Choice and Respect, Dignity of Risk, Open Disclosure and Restraint Minimisation.
• Improving channels of open communication to ensure residents, clients and representatives can easily raise concerns and provide feedback.
• Centralising support services for facilities (such as administration, resident and client accounts, human resources, finance) when it is more economical and sustainable.

The Royal Commission into Aged Care Quality and Safety, in addition to high-profile crisis events at other aged care providers, have highlighted the importance of effective organisational governance in aged care. In fact, organisational governance is now an explicit condition of accreditation for all government-funded aged care facilities under Standard 8 in the new Aged Care Quality Standards.

Standard 8 – Organisational governance

Standard 8 – Organisational Governance, aims to give residents, clients and representatives confidence that an organisation and service is well run, through clear governance structures. It emphasises transparency and open communication between the organisation and consumers, and in holding providers and their Boards accountable for their care delivery. Organisations are expected to promote and integrate a culture of safety and quality into their governance systems, with commitment to ongoing monitoring and continuous improvement. Standard 8 sets specific requirements in managing risk, identifying and reporting abuse and neglect, responsible use of antibiotics, minimal restraint use, and the practice of open disclosure. Communication and reporting throughout all levels of the organisation is key to ensure the proper measures are being taken, most importantly to minimise any risk to residents and clients, in addition to any risk to the Board who are ultimatel accountable.

How does St Vincent’s Care Services demonstrate good organisational governance?

St Vincent’s Care Services’ strategies and tools at facility and service level, right through to senior management level, align with our overall strategy and Mission as set out by the SVHA Board. Decisions made at a governance level guide our ability to provide the very best of care in a long term and economical way, ensuring we remain financially stable, compliant, and meet expectations. Open communication and collaboration is vital, and includes involving residents, clients and representatives in processes such as:
• care plan reviews
• consumer representative volunteers
• feedback forms
• food focus groups
• relative and resident meetings
• surveys.

From everyday actions such as how often each resident room is cleaned and the production of our monthly facility newsletters, to our emergency management plans and information management systems – everything is influenced by the policies and guidelines because of our organisational governance decisions. A lot of this work is behind the scenes, but has a big impact on care delivery, and include:
• Ensuring our systems and workforce meet the needs of residents and clients, with regular upgrades and training, and a culture of continuous improvement.
• Mandatory police checks for all our staff and volunteers.
• Responding to external influences, such as changes in the aged care industry and outcomes from the Royal Commission into Aged Care Quality and Safety.
• Regular meetings of Facility Managers and our Executive team.
• Regular testing of our water and cooling systems, to reduce the risk of Legionnaire’s Disease.
• Reporting to the SVCS and SVHA Finance Committee, the Risk Management and Audit Committee and Executive Leadership Team.

Good organisational governance is in everyone’s interest

Good organisational governance aligns with our Mission and values, and the heritage and legacy entrusted to us by the Sisters of Charity. The Sisters themselves had a strong sense of organisational governance in their decision to transition their ministries to the care of the Trustees of Mary Aikenhead Ministries. They recognised that their health, aged care and education ministries would have greater success in growing and flourishing in a changing world, if a team of religious and lay people who had experience and expertise in these fields governed them. This tradition continues at St Vincent’s Care Services today in transitioning smaller aged care facilities to our services, when their providers are no longer able to operate the facility. This ensures the sustainability of the facility, the ongoing care of its residents, and the continuing compassionate legacy of the organisations who established the facilities.
We rely on input from all stakeholders including residents, clients and their representatives, in order to function and maintain strong organisational governance. With aged care now more focused on individual choice and preferences, the voice of our residents, clients and their representatives has never been more important. We encourage you to play an active role in the organisational governance process at your facility or service, through feedback, collaboration and communication with staff and management. Speak to your Facility Manager or Care Co-ordinator about how you can become more involved.