9. Reassessment and re-rating at request of the approved provider

[ National Law, Sections 138–139 ] An approved provider may apply to the regulatory authority to have a service (including any aspect or element of the service) reassessed and re-rated against the NQS.

While a provider indicates the element(s), standard(s) and quality area(s) they are requesting reassessment on, the regulatory authority may extend the scope of the reassessment beyond those requested by the provider. For example, regulatory authorities may reassess and re-rate the entire quality area when a provider requests a reassessment of part of that quality area.

Application for reassessment and re-rating

An application for reassessment and re-rating can only be made once every two (2) years unless the regulatory authority agrees otherwise.

An application for reassessment and re-rating must be in writing, include the prescribed information and include payment of the prescribed fee.

A regulatory authority may reassess a service or any aspect or element of a service at any time.

[ National Regulations, Regulation 66 ]

Timeframe for conducting the reassessment and re-rating

There is no specific timeframe in which the regulatory authority must reassess and re-rate a service.

Given the reassessment is at the request of the approved provider, the standard timeline for assessment and rating may not need to be applied e.g. the regulatory authority may not give the provider as much notice of the assessment visit. The service may be reassessed sooner if circumstances permit, for example, if the application for reassessment is for one quality area.

Identifying issues during reassessment

During the visit, the authorised officer may note an issue which was not the subject of the reassessment request. This will require case-by-case consideration, but may require the authorised officer to apply the principles of risk assessment to determine the appropriate course of action.

Where an issue is minor and unlikely to change the service’s current rating for that quality area, the regulatory authority may decide not to reassess the area but take some low-level compliance action to address the issue.

Where an issue is more significant and more likely to affect the quality of the service, the regulatory authority may reassess other quality areas or all rooms within the service. As this will be a significant change to the scope of the reassessment, the authorised officer may advise the approved provider of this change.

Regulatory authorities need to decide how they will report on the reassessment. For example, the initial report may be amended with respect to the new ratings, or a new report may be issued with only the reassessed elements of the NQS and ratings.

Factors that influence reassessment and re-rating

In most cases, as part of the continuous quality improvement process that is integral to the NQF, the quality of services would be expected to improve. However, the regulatory authority may decide to reassess a service if it is concerned the quality of a service may have declined over time, or if other risk factors are present. Changes at the service, for example, may result in the decline of a service’s quality. In this case, the regulatory authority may want to reassess and re-rate the service to ensure the rating level of the service accurately reflects the service quality. A regulatory authority may also decide to reassess and re-rate a service if an investigation or other compliance action has taken place.

To amend a rating level, the regulatory authority must undertake an assessment and rating of the service. Reassessments may be undertaken without a visit, if the evidence to be considered does not include observations of practice.