7 Common IPC Failures That Are Putting Aged Care Facilities at Risk of Accreditation Loss

In the dynamic and highly scrutinised landscape of aged care, Infection Prevention and Control (IPC) has emerged as a cornerstone of quality, safety, and, crucially, accreditation. With the introduction of the Strengthened Aged Care Quality Standards, the bar for IPC excellence has been significantly raised. Healthcare professionals working within aged care facilities are acutely aware that IPC is no longer a peripheral concern but a central pillar of operational integrity. Recent audit data from the Aged Care Quality and Safety Commission (ACQSC) consistently highlights that many providers are struggling with repeatable, often preventable IPC failures. These aren't necessarily catastrophic oversights but rather a series of smaller, systemic cracks that, when combined, can lead to compliance breaches and, in the worst-case scenarios, the devastating loss of accreditation.

The consequences of IPC failures extend far beyond regulatory penalties. They directly impact resident health and well-being, erode public trust, and can severely damage an organisation's reputation. For aged care facilities, maintaining a robust and auditable IPC program is not merely a box-ticking exercise; it is an ethical imperative and a strategic necessity. This blog post delves into seven of the most common IPC pitfalls identified in the field, offering insights into why they occur and, more importantly, how they can be effectively addressed to ensure your facility is not only compliant but truly a haven for its residents. To further assist, Infection Prevention Solutions (IPS) has developed a comprehensive guide, "Top 7 IPC Failures That Jeopardise Your Accreditation," which provides practical solutions and a framework for audit readiness. You can download this invaluable resource by clicking here.

The heightened scrutiny on IPC in aged care is a direct response to past challenges and a proactive measure to safeguard vulnerable populations. The ACQSC's intensified focus means that every aspect of an IPC program, from policy to practice, is meticulously reviewed during audits. The data unequivocally shows that many providers are falling short, not due to a lack of intent, but often due to systemic weaknesses in documentation, training, and governance.

The "small" mistakes that recurrently appear in audit reports are often symptomatic of deeper issues. For instance, a missing cleaning audit record might seem minor, but it can indicate a broader deficiency in quality assurance processes. Similarly, frontline staff struggling to articulate IPC practices suggests gaps in training and understanding. These seemingly isolated incidents accumulate, creating a pattern of non-compliance that auditors cannot overlook. The risk is amplified by the unannounced nature of spot checks, demanding a state of perpetual readiness rather than reactive scrambling. Understanding these vulnerabilities is the first step towards building a resilient IPC framework that can withstand rigorous scrutiny and ensure continuous, high-quality care.

Based on extensive experience and ACQSC audit data, here are the seven most prevalent IPC failures that are consistently putting aged care homes at risk:

One of the most significant shifts in the Strengthened Aged Care Quality Standards is the emphasis on continuous quality improvement. For IPC, this means demonstrating an ongoing cycle of review, evaluation, and enhancement. It's not enough to have a static IPC plan; facilities must show how they identify areas for improvement, implement changes, and measure their effectiveness.

Why it fails: Many facilities treat IPC as a set-and-forget task. They might have policies in place but lack a structured system for reviewing incidents, near misses, audit findings, and new evidence to make improvements. There's often no clear documentation of quality improvement activities, meeting minutes that reflect IPC discussions, or evidence of changes made based on feedback or data.

How to fix it: Implement a robust IPC quality improvement framework. This includes regular review of IPC policies and procedures, analysis of infection rates, feedback from staff and residents, and a clear process for implementing corrective actions. Document all improvement initiatives, including the problem identified, the intervention implemented, the outcome measured, and any further actions planned. This could involve regular IPC committee meetings with documented minutes, audit schedules that feed into improvement plans, and staff education sessions based on identified gaps.

Cleaning and environmental hygiene are foundational to effective IPC. Regular, thorough cleaning, supported by meticulous documentation, is non-negotiable.

Why it fails: This failure often stems from a combination of factors: insufficient staff training on cleaning protocols, inadequate supervision, and, vitally, a lack of consistent and accurate record-keeping. Records might be incomplete, illegible, or simply non-existent. Without documented audits, it's impossible to demonstrate that cleaning standards are being met consistently, leaving facilities vulnerable during an audit.

How to fix it: Develop clear, standardised cleaning schedules and checklists for all areas. Implement a regular, documented cleaning audit program, ideally conducted by an independent party or a designated IPC lead. Train cleaning staff thoroughly on proper techniques and the importance of accurate record-keeping. Utilise digital systems for cleaning logs and audits to improve legibility, accessibility, and accountability. Ensure audit findings lead to corrective actions and re-training where necessary.

In an aged care setting, the risk of an infectious disease outbreak is ever-present. A comprehensive, current, and accessible outbreak management plan is critical for a rapid and effective response.

Why it fails: Outbreak plans often become static documents, created once and then left unreviewed. They may not reflect updated current guidelines, the facility's specific layout, or changes in staff roles and responsibilities. Crucially, they may lack detail on communication protocols, surge capacity, or specific actions for different types of outbreaks (e.g., respiratory, gastrointestinal). Additionally, staff may not be familiar with the plan's contents.

How to fix it: Regularly review and update the outbreak management plan, at least annually or after any significant change (e.g., new guidelines, facility renovations, staff turnover). Conduct mock outbreak drills to test the plan's effectiveness and identify areas for improvement. Ensure all staff are familiar with their roles and responsibilities during an outbreak and know where to access the plan. Include clear guidelines on communication with residents, families, staff, and external authorities. Consider specific protocols for managing different disease pathogens.

Antimicrobial resistance is a global health threat, and aged care facilities play a vital role in responsible antimicrobial use. Effective Antimicrobial Stewardship (AMS) programs are now a key component of IPC.

Why it fails: AMS programs often lack clear documentation of their activities, such as regular review of antibiotic prescriptions, analysis of antimicrobial prescribing patterns, or evidence of education for prescribers and staff on appropriate antibiotic use. There may be no documented process for monitoring resistance patterns or for providing feedback to prescribers.

How to fix it: Implement a formal AMS program with clear policies and procedures. This should include a regular review of antimicrobial prescribing, especially for high-risk antibiotics. Document discussions with prescribers regarding appropriate indications, duration, and choice of antimicrobials. Monitor antimicrobial use and resistance patterns within the facility and provide feedback to relevant staff. Conduct regular education sessions for medical officers, nurses, and care staff on AMS principles and guidelines. Collaborate with pharmacists and infectious disease specialists where possible.

A designated and empowered IPC Lead is crucial for driving and maintaining an effective IPC program. Their role, responsibilities, and authority must be clearly defined and understood across the organisation.

Why it fails: Often, the IPC Lead role is assigned without a clear job description, adequate time allocation, or the necessary authority to implement changes. The individual may be overburdened with other duties, lack specific IPC qualifications, or not have the organisational backing to truly lead the team. This ambiguity leads to a reactive approach to IPC rather than a proactive, strategic one.

How to fix it: Clearly define the IPC Lead role, including their responsibilities, reporting lines, and authority. Ensure the IPC Lead has appropriate qualifications and provides opportunities for ongoing professional development. Dedicate sufficient time and resources to the role. Document the IPC Lead's scope of practice and ensure this is communicated to all staff. The IPC Lead should be involved in strategic planning related to IPC and have the authority to implement necessary changes.

Ultimately, the effectiveness of an IPC program rests on the daily practices of frontline staff. During an audit, the ability of the staff to articulate their understanding and application of IPC principles is critical.

Why it fails: This is often a symptom of inadequate or infrequent IPC training, or training that is theoretical rather than practical. Staff may know what to do but struggle to explain why or how their actions contribute to the overall IPC. High staff turnover can also exacerbate this issue, as new or temporary staff may not receive comprehensive induction training, especially in an outbreak.

How to fix it: Implement a comprehensive, ongoing IPC training program for all staff, tailored to their roles. Training should include practical demonstrations and opportunities for staff to articulate their understanding. Conduct regular competency assessments. Encourage a culture of continuous learning and open communication where staff feel comfortable asking questions and seeking clarification. Provide readily accessible IPC resources (e.g., posters, quick guides). During audit preparation, conduct mock interviews with staff to boost their confidence in verbally discussing IPC practices.

IPC is not just an operational issue; it is a significant organisational risk that must be managed at a governance level. Failure to integrate IPC risks into the broader organisational risk register indicates a fundamental gap in risk management.

Why it fails: IPC risks are often viewed in isolation, managed solely within the clinical or nursing department, without being presented to the governing body. This can lead to under-resourcing, a lack of strategic oversight, and a failure to allocate sufficient attention and investment to IPC initiatives.

How to fix it: Ensure IPC risks are formally identified, assessed, and included in the organisation's risk register. Assign clear accountability for managing these risks at a governance level. Report on IPC performance and risk-mitigation strategies to the board or governing body regularly. Demonstrate how IPC insights inform strategic decision-making and resource allocation within the organisation. This ensures IPC is seen as a core business risk, not just a clinical one.

The good news is that every single one of these common IPC failures is 100% fixable. The key lies in a proactive, systematic, and well-documented approach. Rectifying these issues before your next unannounced spot check is of paramount importance.

To assist aged care providers in navigating these challenges, Infection Prevention Solutions (IPS) has developed a comprehensive guide, "Top 7 IPC Failures Guide," which offers practical explanations of each risk, quick fixes you can implement immediately, and a simple framework to get your IPC program audit ready. You can download this invaluable resource here.

Inside the guide, you will find actionable strategies such as:

• Practical Explanations of Each Risk: Delving deeper into the 'why' behind each failure, offering a clearer understanding of the root causes.
  
  
• Quick Fixes You Can Implement This Month: Immediate, tangible steps that can be taken to mitigate the most pressing risks and demonstrate a commitment to improvement.
  
  
• A Simple Framework to Get Your IPC Program Audit-Ready: A structured approach to assessing your current IPC status, identifying gaps, and developing a roadmap for comprehensive readiness.
  
  

Beyond the guide, consider these overarching strategies:

Infection Prevention and Control is no longer merely a compliance requirement; it is a fundamental pillar of quality aged care. The Strengthened Aged Care Quality Standards have unequivocally raised the stakes, demanding a proactive, systematic, and continuously improving approach to IPC. The seven common failures outlined in this post – from lack of continuous improvement evidence to an absence of governance linkage – are prevalent, but they are also entirely preventable.

For healthcare professionals in aged care, understanding these pitfalls is the first step towards safeguarding your facility's accreditation and, more importantly, ensuring the health and safety of your residents. By addressing these risks head-on, implementing robust systems, fostering a culture of IPC excellence, and leveraging available resources, aged care facilities can transform potential vulnerabilities into strengths.

• IPC is a High-Risk Area: The ACQSC's intensified scrutiny means IPC failures are common and can lead to accreditation loss.
• Continuous Improvement is Key: Demonstrate ongoing efforts to review, evaluate, and enhance your IPC program, with clear documentation.
• Documentation is Non-Negotiable: Meticulous records for cleaning audits, outbreak plans, and AMS activities are crucial evidence of compliance.
• Empower Your IPC Lead: Ensure your IPC Lead has a clear role, sufficient resources, and organisational authority.
• Train Your Frontline Staff: Equip all staff with the knowledge and confidence to articulate and practice IPC effectively.
• Integrate IPC into Governance: Link IPC risks to your organisational risk register and ensure leadership oversight and investment.
• Proactive Fixes are Essential: All common IPC failures are fixable, but require prompt, systematic intervention before unannounced audits.

We created the "Top 7 IPC Failures Guide" because we see too many providers suffer from avoidable compliance issues during IPC reviews. Do not let these 7 risks jeopardise your accreditation. Download the free guide now.