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Frustration over Royal Commission


The head of a leading aged care provider has expressed frustration over the announcement of a Royal Commission into the aged care sector, saying it is a “shame” things have reached this point.

Sandra Hills

Benetas CEO Sandra Hills says it is clear that by announcing the inquiry the government is taking aged care seriously, and the Victorian-based not-for profit welcomed this.

“Benetas supports any move by Government to give older Australians the care, respect and support they need,” she said. “But, as a provider that constantly strives for better quality outcomes for our residents and customers, we feel it is a shame that the sector is now at this point.”

She said it was frustrating that after 15 enquiries the government had still not addressed continuing concerns.

“In light of the myriad of reviews to date, we’re asking whether or not the Royal Commission will achieve the outcomes sought.”

Estia Health CEO Norah Barlow said Estia welcomed any measures to ensure the safety and quality of care of residents and said the provider would continue to work with the government to build a viable sector.

“Estia looks forward to engaging in the consultation with government to the terms of reference for the commission,” she said.

Meanwhile aged and disability home services provider Australian Unity said it welcomed any move to improve access and quality of care across the sector.

“We particularly welcome any focus on how Australia addresses the looming shortfall in aged care workers,” an Australian Unity spokesperson told Australian Ageing Agenda.

“It will require all those involved in the delivery of aged care, including providers, government and unions, to work together to avert this looming crisis.”

The comments came a day before the airing of an ABC Four Corners investigation into the aged care sector, which contained allegations of abuses, short staffing, excessive use of medication and neglect of residents in aged care facilities.

An increase in complaints

The inquiry, announced by Prime Minister Scott Morrison on Sunday, will investigate the quality of care of not only the aged care and home care sector, but also young people with disabilities currently living in Australian residential care facilities (read more here).

The announcement follows numerous calls to the Government after serious failures were reported at the Oakden facility in Adelaide in 2017.

A report on aged care regulation in quality from the Department of Health shows that during the 2016-17 financial year, the Aged Care Complaints Commissioner received a total of 3654 complaints in the residential aged care sector, which saw an 18 per cent increase in complaints during 2017-18 (4315).

For home and community care, the number of complaints from 2016-17 (1057) to 2017-18 (1464) had increased by 39 per cent.

The number of notices of non-compliance related to quality issued to providers by the Department of Health increased by 185 per cent from 2016-17 to 2017-18.

Independent MP Rebekha Sharkie, who has introduced a private members bill into parliament that would require providers to publish their staff-to-resident ratios,  said the Royal Commission mustn’t be used to delay much-needed changes to the sector.

“We need to act quickly to address our community’s very real concerns about understaffing and the low (sometimes non-existent) number of registered nurses in our aged care facilities as well as poor training and retention rates for aged care workers,” she said.

The Older Persons Advocacy Network said urgent action was needed to improve the quality of care.

OPAN CEO Craig Gear said the Royal Commission must not stop investment into other areas including staff, training, advocacy and improving quality now.

“After a senate inquiry and a parliamentary probe, it is clear that we are seeing an industry under extreme pressure and more needs to be done,” Mr Gear said.

“A Royal Commission is supported if it leads to long term change to protect older people, and we need action now,” he said.

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9 Responses to Frustration over Royal Commission

  1. Gail Worthington September 18, 2018 at 7:36 pm #

    Sandra, (and all CEOs) choose any site you like. Come spend a few hours with me and I’ll show you what’s really going on out there.

    I’ll guarantee we’ll have a fun-filled day observing poor wound care, rubbish manual handling techniques, zero behaviour management skills, polypharmacy, chronic dehydration, overworked staff, task-oriented work practices and a host of other popular aged care highlights.

    It’s time we started realising that aged care leaders must have direct care experience. Without this they just don’t know what they don’t know.

  2. Heather September 19, 2018 at 12:19 pm #

    Is the fact that we have staff ratios in childcare and not in aged care discriminatory in relation to age? Is society saying that ratios are welcomed in childcare but not in Aged Care? Do we believe that a child is more deserving of the right level of care, but not an Aged Person? WE NEED RATIOS TO HAPPEN IN AGED CARE – and those ratios need to factor in the levels of care (appropriate qualification) and also levels of need of the consumer (on a scale)

  3. Anonymous September 19, 2018 at 12:31 pm #

    Really good people could be working as personal carers / aged care workers, but the working conditions are poor and training is inadequate and too expensive. If the funding for training only goes to those who have no previous qualifications (Cert 3 guarantee) or to those who are being pushed into it by employment agencies, then we are limiting lots of wonderful people who want to work in aged care and disability but cant afford the training. Offer free training to those who really want to work alongside our elders. Also, a 3 month course with 120 hours of placement is not going to give people the complex skills they need to work in the industry. Newly trained staff should be supported on the job with extra training and mentoring and not be told to focus on time management and left out of care planning and reporting process (which happens in some facilities). Some of the older nursing staff and management also need to come up to date with person centre care and innovations and creative ideas that work successfully in more progressive countries. Older people need companionship and time to accomplish tasks, dignity and respect, just like other members of society- who will all get old one day. Put more personal carers into the workforce and reward them for the jobs they do. Offer them extra training and career advancement.

  4. Sally Hogan September 19, 2018 at 1:13 pm #

    How do ratios work in an environment that provides individualised, person-centred care?

    Ratios work in acute care because it is possible to reasonably identify time required to complete specific clinical care tasks related to specific types of acute care.

    Ratios work in child care because there are vast similarities in the needs and time required to attend those needs for each child.

    Ratios WON’TWORK in aged care because within any facility there are a vast mixture of individuals with vastly different care needs. Additionally, staffing ratios would have to specifically apply to direct care to have any impact – already there are facilities that use significant proportions of staff funding to pay high level executive staff who are never directly involved with clients.

    To specify staffing ratios simply won’t work. I believe that a better, more workable solution is to advocate a minimum percentage of revenue that must be allocated to direct-care staffing.

  5. Heather September 19, 2018 at 2:15 pm #

    Childcare is an industry that requires individualised person centred care just as aged care. Children come with an assortment of conditions, abilities etc just as the aged, There are different ratios for different stages of development etc in childcare. Just as in childcare, the same applies in aged care, there are different levels of care required, so ratios need to be factored according to these variations – the level of need of the consumer. Of course ratios relating to qualifications of staff also need to be taken into consideration when looking at the different levels of care required.

  6. Leslie Scobie September 20, 2018 at 11:33 am #

    The recently announced Royal Commission into Aged Care must include Retirement Villages.

    An important point is that retirement villages operate under state laws not federal laws as is the case with residential aged care.

    The industry direction for residential Aged Care and Retirement Villages is a closer relationship and where possible a joint facility. The operator becomes a registered care provider and delivers home care packages to the residents of the retirement village section.

    This leads to older Australians spending a longer period in a retirement village and a subsequent shorter period in a residential aged care facility. Sounds ok but critically this will mean older Australians will spend most of their latter years under State Government legislation rather than Commonwealth legislation.

    One glaring example of the danger in this situation is –

    Under federal law it is mandatory for an aged care operator to have an emergency evacuation plan and assembly point. Under Victorian retirement village law there is no mandatory requirement for a retirement village operator to have an emergency evacuation plan or assembly point.

    Professor Tim Kyng from Macquaire University and Paul Latimer from the Swinburne Law School have both made persuasive arguments for retirement villages to come under federal law.

    https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3030570

    https://www.parliament.vic.gov.au/images/stories/committees/SCLSI/Retirement_Housing/FINAL-SCLSI-RHS-16112016-MU.pdf

    https://www.parliament.vic.gov.au/images/stories/committees/SCLSI/Retirement_Housing/RH-Presentation-16112016-MU.pdf

    Retirement villages INCREASE the number of older Australians that are dependent on the taxpayer funding for aged care such is the financial destiny of retirement village residents. A flatter or falling property market into the future will make it even worse. When it comes time to enter an aged care facility older Australians living in retirement villages require this increased taxpayer funding as a result of the ‘deferred management fee’ purchasing mechanism inherent in retirement villages.

  7. Tony Schumacher-Jones September 26, 2018 at 9:24 am #

    In the light of recent terrible events we have witnessed on television, one might be forgiven for asking; how is it possible we have reached this point?

    That is, anyone who has worked in residential aged care, as a carer, or RN, or EN, or DT, for at least a day would be well acquainted with its shortcomings. So I find myself thinking, what on earth were the peak bodies doing over the past decade to mitigate against the excesses of this crisis driven industry?

    I am talking about Alzheimer’s Australia or in its current iteration, Dementia Australia, as one of the major ones.

    Dementia Australia, as its name suggests, is the peak body for those people who have a dementia. The majority of people in residential care have some form of cognitive impairment, if not a diagnosed dementia. So where was Dementia Australia when all this stuff was going on?

    Did they know about it?

    If they did, then why did it take a media report to lift the lid on residential care? I think that, in general, the peak bodies, as they like to call themselves, have a lot to answer for. I hold them at least partially (a big part) of the problem. They have certainly not been part of the solution!

  8. Johanna Aalberts- Henderson September 26, 2018 at 2:59 pm #

    As a family member of an older adult who was under cared in a facility that now has sanctions in placef; I have three suggestions
    1. Increase and regulate staffing numbers. Profit appears to be the driver in the Aged Care sector. No one would argue that profit shouldn’t be attained, but at the cost of basic care?
    2. Educate PCA’s in basic nursing care. eg pressure area care, understanding of aging etc. At the moment it appears that funded educational providers are not even coming to a basic knowledge base in education. Again profit comes before education.
    3. All aged care facilities should have random spot checks as well as questions that require accountability. eg ‘do any of your patients have pressure sore? Have any of your patients had falls, how many and what was the care regimen? And, get those who audit to physically see and notate what they find.
    As an ‘old trained Div 1. nurse, I was stunned at the lack of concern and accountability in my mothers care.
    Profit yes, but at what cost?
    Humanity loses.

  9. kylie wise September 26, 2018 at 4:12 pm #

    Your argument doesn’t pass muster, Sally.

    Acute care surgical wards have a mix of pre-op, post-op and longer term patients. Some days its busy, others not so much. It’s far from a set and predictable workload.

    If you’ve worked in aged care at all you’d know that the the workload doesn’t vary all that much, the ‘turnover’ isn’t as frequent as acute and they all require high care. It’s not difficult to get the staff mix right.

    Ratios aren’t intended to fund executive salaries, they apply to direct care staff.

    Mandating a percentage of revenue to spent on staffing is absurd. Wages already account for 60% – 70% of operating expenses…how would you manage the difference in revenue (and resulting percentage ) between a 150 bed facility compared to a 50 bed ?

    Provides have lost the trust of the community. Mandating ratios is the only way to ensure your granny doesn’t lie in bed for 20 hours every day

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