Released late on Thursday (31 October), the Royal Commission into Aged Care Quality and Safety’s interim report found that a uniform provision of quality and safe care is severely lacking, and in many instances actually neglects the very people it is supposed to support.
“The neglect that we have found in this royal commission, to date, is far from the best that can be done. Rather, it is a sad and shocking system that diminishes Australia as a nation,” commissioners Richard Tracey and Lynelle Briggs said.
The report called for immediate action on three key areas – well before its full list of recommendations are handed down in the final report, not due for release for another year (on 12 November 2020).
Those actions, it said, are:
- for the provision of more Home Care Packages, in order to cut waiting lists for higher level home-based care
- for a wholistic response to the sector’s “over-reliance” on chemical restraint
- for a cessation in younger people with a disability being pushed into aged care programs and facilities, at the same time as a speeding up of the process to remove such individuals already in aged care
According to the report, a number of systemic issues have already been identified within the aged care sector, which include:
- the industry being focused on transactions rather than care and relationships
- a stifling of the opinions and desires being expressed by those in care and their loved ones
- an overly complex system blocking informed decision-making by those in care
- a pressured and underappreciated workforce lacking in core skills
- a lack of transparency and incentivisation to improve under the current regulatory framework
Indeed, regulation and red tape over many years have created a “complex, confusing, bureaucratic maze”, according to the report, which also took aim at the secretary of the federal Department of Health.
“The secretary of the Australian Department of Health told the royal commission that ‘based on the evidence and information available to the department… serious instances of substandard care do not appear to be widespread or frequent’. We beg to differ,” the report said.
“The personal experiences of older people and their friends and families, which have been provided to the royal commission through submissions and hearings and at community forums, suggest that the quality of care provided within Australia’s aged care system is variable. The quality of aged care can fall well short of expectations and, at worst, allow substandard care to occur.”
Employment and staffing issues were also deemed to be “relevant to every aspect of our inquiry”, suggesting that “most people working in aged care are doing their best, and that many of them are doing so in difficult circumstances”.
‘Will require more than just new rules’: industry response
Industry was quick to offer initial response to the interim report, with Aged and Community Services Australia (ACSA) stating that slapping yet more rules on the aged care industry won’t resolve the problems identified.
“It’s not a surprise to anyone there are failures in aged care. We are living longer than ever before and our health needs are increasingly complex. The system wasn’t set up for this,” its CEO Patricia Sparrow said.
“So far, the understandable focus on mistakes of the past has put the investigation of possible financing models and big-picture solutions on the back burner.
“It’s very important to hear when and how things have gone wrong, but unless we get specific recommendations about how government, providers and the community can work together to better plan for our ageing population – new rules will be meaningless and impossible to realise.”
Ms Sparrow said that more than just new rules, “absolutely critical [to initiating positive change] will be new funding solutions and large-scale community education about ageing and aged care”.
“There are some hard conversations that are still being avoided,” she said.
“The big improvements we are working towards in aged care at the moment won’t be fully realised unless we see a commensurate response on the structure of and funding for the sector, and the entire community taking responsibility for our ageing population.”
ACSA is pushing for “five urgent priorities” that it said will sure up the aged care industry’s ongoing viability, including:
- Extending the short-term 9.5 per cent funding injection into residential care, tied to investing in staffing, training and other workforce matters based on local and organisational needs, as a temporary measure until the royal commission’s broader recommendations can be implemented.
- An immediate boost of 40,000 level 3 and 4 Home Care Packages.
- Increasing the rural and remote supplement by $10 per day, in order to keep rural and regional Australians in their communities.
- Addressing oral health in aged care to prevent escalating health issues.
- Bringing forward the 30 per cent increase to the homeless supplement.
More detailed responses from the industry are expected over the coming days as they weigh through the report.
The full interim report, which is published in three separate volumes, can be viewed on the royal commission’s website. Submissions to the commission will be open until 30 April 2020.