‘How provider organisatons interpret regulation in the context of residential dementia aged care’ examines how Australian residential aged care provider organisations respond, interpret and comply to regulation.

Special attention is paid to how this affects organisational culture, administration and ultimately the degree and quality of person-centred care offered, such as knowing individual biographies, awareness of individual likes and dislikes, and attention to moods and feelings. An important observation was that specific skills are needed at different levels of an organisation, depending on their relationship to the processes of regulation and governance.

This research has an important policy impact as it provides an “on the ground” window into the effect of balancing competing administration priorities for compliance and how they affect dementia care. The study found provider organisations adopted many strategies to meet compliance that largely fitted into the responses of “above and beyond,” “pushing back” or “engineering out”.

The study found organisations respond differently to different forms of compliance and this in turn affects how care is delivered and the quality of life of residents. “For instance, requirements related to building design and fire safety could create an institutional environment that is not homelike, or rules around food provision may prevent resident choice.”

The authors argue that in Australia, the processes of regulation and compliance are unnecessarily complex and that a ‘stacking approach’, based on areas of expertise in specific areas, should be adopted. While regulation does create extra tasks for provider organisations, these ultimately contribute to improved care. They also recommend that training should be tailored to the different organisational levels associated with managing regulatory demands.

Finally it is argued that greater attention should be paid to the emotional stresses associated with balancing care and compliance.

The article concludes that regulation should allow providers to balance better the complex needs of care and risk,. “They can contribute to an architecture of risk mitigation that simultaneously allows the humanity of the task to shine through.”

(Authors: Simon Biggs and Ashley Carr)