Legislative background
20 The provisions which are central to these proceedings are to be found in Pt 4.4 of the Act. That Part concerns what are described as "Consequences of non-compliance". Under the relevant provisions, the Secretary may impose sanctions on an "approved provider" that does not comply with its responsibilities under the Act. However, detailed procedures must be followed before any such sanctions are imposed.
21 The key provision is s 65-1 which provides:
"65-1 Imposition of Sanctions
The Secretary may impose sanctions (see Division 66) on an approved provider if:
(a) the approved provider has not complied, or is not complying, with one or more of its responsibilities under Part 4.1, 4.2 or 4.3; and
(b) the Secretary is satisfied that it is appropriate to impose sanctions on the approved provider (see section 65-2); and
(c) the Secretary complies with the requirements of Division 67.
Note: Decisions to impose sanctions are reviewable under Part 6.1."
22 Section 65-2 sets out a number of matters which the Secretary must consider when determining whether it is appropriate to impose sanctions on an approved provider for non-compliance with one or more of its responsibilities.
23 Section 66-1 lists, in apparent descending order of gravity, the sanctions that may be imposed by the Secretary. That section relevantly provides:
"66-1 Sanctions that may be imposed
The Secretary may, by notice in writing, impose one or more of the following sanctions on an approved provider that has not complied, or is not complying, with one or more of its responsibilities under Part 4.1, 4.2 or 4.3:
(a) revoking or suspending the approved provider's approval under Part 2.1 as a provider of aged care services;
(b) restricting the approved provider's approval under Part 2.1 as a provider of aged care services to aged care services that are being conducted by the approved provider at the time the sanction is imposed;
(c) restricting the approved provider's approval under Part 2.1 as a provider of aged care services to either:
(i) care recipients to whom the approved provider is providing care at the time the sanction is imposed; or
(ii) care recipients other than those to whom the approved provider commenced providing care, through one or more specified aged care services, after the time the sanction is imposed;
(d) revoking or suspending the allocation of some or all of the places allocated to the approved provider under Part 2.2;
(e) varying the conditions to which the allocation of some or all of those places is subject under section 14-5;
(f) prohibiting the further allocation of places under Part 2.2 to the approved provider;
…"
24 Section 67-1 provides:
"67-1 Procedures for imposing sanctions
(1) The Secretary must not impose sanctions on an approved provider for not complying with one or more of its responsibilities under Part 4.1, 4.2 or 4.3 unless the Secretary has completed each of the following steps:
(a) giving to the approved provider a notice of non-compliance (see section 67-2);
(b) giving to the approved provider:
(i) a notice of intention to impose sanctions (see section 67-3); or
(ii) a notice to remedy the non-compliance (see section 67-4); or
(iii) a notice of intention to impose sanctions in respect of a specified part of the non-compliance (see section 67-3) and a notice to remedy the remainder of the non-compliance (see section 67-4);
(c) giving to the approved provider notice of the Secretary's decision on whether to impose sanctions (see section 67-5).
(2) However, paragraphs (1)(a) and (b) do not apply if the Secretary is satisfied that, because of the approved provider's non-compliance, there is an immediate and severe risk to the safety, health or well-being of care recipients to whom the approved provider is providing care."
25 Section 67-5 requires the Secretary to notify the approved provider, in writing, of the Secretary's decision on whether to impose a sanction on the approved provider in respect of non-compliance by the approved provider with its responsibilities. If the Secretary decides to impose a sanction, the notice must set out the matters described in s 67-5(2).
26 Not surprisingly, the Act makes detailed and elaborate provision for the reconsideration and review of decisions. Section 85-1 sets out, in a table, a series of decisions, each of which is said to be a "reviewable decision". Item 54 of that table renders a decision by the Secretary to impose a sanction on an approved provider, which is made under s 65-1, a "reviewable decision".
27 Section 85-5(1) provides that a person whose interests are affected by a reviewable decision may request the Secretary to reconsider that decision. Section 85-5(5) provides that, after receiving the request the Secretary must reconsider the decision, and confirm, vary, or set it aside.
28 Section 85-8 provides:
"An application may be made to the Administrative Appeals Tribunal for the review of any reviewable decision that has been confirmed, varied or set aside under section 85-4 or 85-5."
29 The effect of s 85-8 is that the Administrative Appeals Tribunal ("the AAT") may only review a reviewable decision after the Secretary has first been requested to reconsider that decision, and has either confirmed, varied or set it aside.
30 It is necessary to say something about the provisions of the Act which set out the responsibilities of approved providers. Section 53-1 indicates that these responsibilities relate to:
· the quality of care they provide (see Pt 4.1);
· user rights for the people to whom the care is provided (see Pt 4.2); and
· accountability for the care that is provided (see Pt 4.3).
31 Section 54-1 sets out the responsibilities of an approved provider in relation to the quality of the aged care that the approved provider provides. These responsibilities include:
· to provide such care and services as are specified in the Quality of Care Principles in respect of aged care of the type in question;
· to maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met;
· if the care is provided through a residential care service after the accreditation day - to comply with the Accreditation Standards made under s 54-2; and
· if the care is provided through a residential care service before the accreditation day - to comply with the Residential Care Standards made under s 54-3.
32 The Quality of Care Principles to which reference is made in s 54-1 are those made by the Minister under s 96-1 (see Item 18). The accreditation day to which reference is made is defined in s 42-4(2) as the day specified in the Residential Care Subsidy Principles made by the Minister under s 96-1, or, if no such day is specified, 1 January 2001.
33 Section 54-2 provides:
"54-2 Accreditation Standards
(1) The Quality of Care Principles may set out Accreditation Standards. Accreditation Standards are standards for quality of care and quality of life for the provision of residential care on and after the accreditation day.
(2) The following are examples of matters with which the Accreditation Standards may deal:
(a) health and personal care of care recipients;
(b) the lifestyle of care recipients;
(c) safe practices and the physical environment in which residential care is provided;
(d) management systems, staffing and organisational development relating to the provision of residential care."
34 Section 54-3 provides that the Quality of Care Principles may set out "Residential Care Standards". These are standards for quality of care and quality of life for the provision of residential care before the accreditation day. The examples of matters with which the Residential Care Standards may deal are similar, but not identical, to the examples of matters with which the Accreditation Standards may deal.
35 Section 80-1 provides:
"80-1 Accreditation grants
(1) The Secretary may, on behalf of the Commonwealth, enter into a written agreement with a body corporate under which the Commonwealth makes one or more grants of money to the body for the following purposes:
(a) accreditation of residential care services in accordance with the Accreditation Grant Principles;
(b) any other purposes specified in the Accreditation Grant Principles, including the performance of any of the functions of the Secretary under this Act that are specified in the Accreditation Grant Principles.
A grant of money under this subsection is an accreditation grant.
Note: The Accreditation Grant Principles are made by the Minister under section 96-1."
36 The Accreditation Grant Principles to which reference is made in s 80-1 are the 1998 and 1999 Principles. These Principles were made by the Minister under s 96-1 (Item 2). Section 96-1 relevantly provides:
"(1) The Minister may make Principles, specified in the second column of the table, providing for matters:
(a) required or permitted by the corresponding Part or section of this Act specified in the third column of the table to be provided; or
(b) necessary or convenient to be provided in order to carry or give effect to that Part or section.
…
(2) Principles are disallowable instruments for the purposes of s 46A of the Acts Interpretation Act 1901."
37 Section 80-1(2) sets out a series of examples of matters with which the Accreditation Grant Principles may deal. These include the procedures to be followed in deciding whether to accredit a residential care service, and the procedures to be followed in revoking or suspending the accreditation of such a service.
38 The "body corporate" to which reference is made in s 80-1 is the Agency, which is the fourth respondent in each of these proceedings.
39 The 1998 Principles operated throughout 1998, until they were revoked on 2 September 1999. They were replaced by the 1999 Principles which came into operation on that date. Both sets of Principles set out the procedures to be followed, and the matters to be taken into account, when assessing residential care services, and the conditions to which grants may be subject.
40 Section 2.5 of the 1998 Principles set out the functions to be performed by the Agency. That section provided:
"2.5 Assessment of residential care services
1. The accreditation body must arrange for assessments of residential care services to be conducted during the transition period.
2. An assessment of a residential care service must take into account whether the level of care provided by the service to care recipients complies with the Residential Care Standards.
3. The accreditation body may use any of the following indicators to decide the order in which residential care services are to be assessed:
a. any change of ownership of the services;
b. the number and seriousness of complaints made against the service;
c. the length of time since the service was last assessed;
d. the results of previous assessments of the service."
41 Section 2.6 set out the procedures for assessment of residential care services. Section 2.7 made provision for the publication of assessment reports. Section 2.8 required the Agency to make available to anyone who requested it a copy of an approved assessor's report.
42 Section 2.9 set out the consequences of failure to comply with the Residential Care Standards. Relevantly it provided:
"1. If, in performing its functions, the accreditation body identifies a failure by a residential care service to comply with the Residential Care Standards, the accreditation body must decide whether the failure has placed, or may place, the safety, health or wellbeing of persons receiving care through the service at serious risk.
2. If the accreditation body decides that the failure has placed, or may place, the safety, health or wellbeing of persons receiving care through the service at serious risk, the accreditation body must immediately tell the Secretary and the service, in writing, about the failure and any concerns of the accreditation body.
3. If the accreditation body decides that the failure has not placed, and will not place, the safety, health or wellbeing of persons receiving care through the service at serious risk, the accreditation body must tell the residential care service, in writing, about:
a. the areas in which improvements must be made by the service to ensure that it complies with the Residential Care Standards; and
b. the timetable to make improvements in the areas; and
c. the program of visits by an approved assessor to assess progress made by the service in making improvements in the areas.
…"
43 The balance of s 2.9 set out a detailed timetable for action in such cases.
44 The 1999 Principles are very similar to the 1998 Principles. Part 4 of the 1999 Principles deals with non-compliance with the 1999 Principles. A distinction is drawn between residential care services provided before 1 January 2001, and services provided after that date. Division 2 applies in respect of residential care services provided before 1 January 2001, while Division 3 applies in respect of accredited residential care services provided on and after that date.
45 Section 4.2 of the 1999 Principles deals with evidence of serious risk to residents in respect of services provided before 1 January 2001. That section provides:
"(1) If a desk audit, site audit or review audit of a residential care service finds evidence of a serious risk to the health, safety or wellbeing of a person receiving care, the accreditation body must, as soon as it becomes aware of the evidence:
(a) tell the Secretary, in writing, about it; and
(b) give a copy of the report, and other relevant documents, to the Secretary, and the approved provider that operates the service, as soon as practicable.
(2) A report for paragraph (1)(b) must include:
(a) specific information about the reason for the risk, and evidence of the risk; and
(b) recommendations to the Secretary about whether or not sanctions under the Act should be imposed on the approved provider; and
(c) a statement of any standards or outcomes that have not been complied with; and
(d) any improvement outline that the accreditation body considers appropriate in the circumstances."
46 Section 4.3 deals with evidence of non-compliance with one or more of the approved provider's responsibilities under Pt 4.1, 4.2 or 4.3 of the Act. That section imposes upon the Agency reporting responsibilities which are similar to those imposed upon the Agency under s 4.2.
47 Division 2 requires residential care services to comply with the Residential Care Standards. Residential care services are expected to work towards achieving accreditation in accordance with the Accreditation Standards. Accreditation will only be given to residential care services that can demonstrate compliance with those Standards.
48 Division 3 requires residential care services that are accredited on and after 1 January 2001 to comply with the Accreditation Standards, and to demonstrate continuous improvement, measured against those Standards.