MORE expected from the Royal Commission into Aged Care Quality and Safety

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I am looking forward, with timidity, to reading and reviewing the final report from the Royal Commission into Aged Care Quality and Safety.

As you might recall, I retired on 1 November 2019 on grounds of ill following an almost 40 year career in aged care management and leadership, and three Chief Executive Officer positions totaling more than twenty years.

In my view, whilst the funding is the highest it has ever been, the care provided within that funding is at least as poor as that provided in the mid 1980s which prompted the (Senator) Giles review into nursing homes.  In my view, based on a competent clinical assessment of their health and multiple morbidities with which most seniors approach care services for support, our current aged care system, whether for residential and/or home based care, is unable to guarantee that each care recipient will receive the care they need, let alone want.

The aged care sector needs MORE:

  • More funding for care;
  • More staffing for care;
  • Mandated minimum staff mix ratios expressed as a required hours and minutes per day based on the appropriate assessment of clinical and support needs of residents and home care clients;
  • More training for staff;
  • More regulatory oversight by an assessment/audit authority (with teeth) that can fine and disqualify company directors and/or officers for breaches of regulatory compliance;
  • More transparency about where the $ billions are spent each year, particularly in profits and shareholder dividends (away from care);
  • More input from feet on the ground consumer advocacy groups;
  • More transparency and exposure of inappropriate care that endangers aged care recipients’ health, well-being, and safety;
  • More initiatives for care and accommodation services for –
    • People living with dementia; and
    • Older, frail (mainly) women at risk of homelessness, but reliant on a pension only, due to lack of sufficient retirement funds to support private accommodation. 
  • More high care community aged care packages made urgently available in communities where they are needed, along with a contemporaneous moratorium on the issuing of residential aged care places in those communities so that our dependence on residential aged care is lowered; and
  • More research into financing models making use of occupational superannuation or similar insurance funding, for example, making use of a wage rise incentive for more superannuation, but the relevant contributions set aside with regulation for later use in instances of aged care and/or disability care services and related purposes.

Mine is a long list, but I think not unreasonable. And I have likely omitted to mention some that I should have included.

My own work on minimum staffing requirements (here) back in 2018 suggests about an additional $6 billion to have a workforce sufficient in number and training to appropriately care for our most frail if elders.  Today many residential aged care services do not even have a registered nurse on duty 24 X 7, with perhaps only one or two staff for 100 or more residents.  In my view this is a shameful outcome of what has been, in hindsight, some thirty-five years of failure of what promised to be an innovative Aged Care Act in Australia.

There is going to be tough times ahead for all involved and the final report/s are likely going to make for difficult reading.  But they must be both read and acted upon.

The question is, will the Australia Government have the appetite and conviction to introduce rights based changes in care for our elderly. Or will older Australians face an uncertain future with respect to their care needs in later life?

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