Concerns over focus on ‘safety’ in new aged care standards as facilitating consumer choice often involves a level of risk.
Experts have welcomed the government’s moves towards adopting a more sophisticated quality framework where the monitoring of aged care providers depends on the risk profile of their services and their compliance history.
But they say providers should be assessed on how they improve residents’ quality of life rather than against outdated concepts of “safety”, which could inhibit the personal freedoms of those living in residential care.
The government last week released three options for streamlining the assessment of aged care providers against new draft standards.
To varying degrees each option would see quality assessment take into account an aged care provider’s history, the perceived level of risk in its service and its compliance with quality systems in other areas where it operates, such as disability.
- What are the new options? Read AAA’s backgrounder here
Professor Marita McCabe, director of the Institute for Health & Ageing at the Australian Catholic University, said she welcomed the moves to take a provider’s track record into account.
“It would be sensible to base assessment on previous performance rather than putting everyone through the same process because accreditation is a massive process that holds everything up for organisations while they’re going through it,” Professor McCabe told Australian Ageing Agenda.
However, Professor McCabe said she was concerned about the standard’s numerous references to protecting the “safety” of residents given the push in recent years had been on empowering older people and facilitating individual choices.
Professor McCabe said her concern is that the proposals are “still talking about wrapping consumers in cotton wool and making sure that they are safe.”
This focus on safety was a “bit of a disconnect” with the standards’ other references to much more contemporary concepts such as consumer dignity, autonomy and choice, she said.
“Inherent in consumer choice is the notion that there may well be accidents, because if I say I want to go out and do some gardening or I want to go dancing, then I may stumble or trip. So ‘safety’ in that traditional medical sense may well be compromised,” she said.
For years, aged care providers and consumer groups have criticised the current regulations for taking a paternalistic approach that puts the avoidance of risk ahead of facilitating consumers’ individual preferences and wishes.
Professor McCabe also highlighted that the sector is still largely without agreed and validated assessment tools to measure the more nuanced facets of aged care quality.
“We can easily measure how many infections there have been, how many broken hips, the compliance with medication, but how do you measure dignity, autonomy and choice, and all the other things listed on the standards,” she asked.
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