A “significant” imbalance of power has made residents and home care recipients fearful of making complaints, the royal commission into aged care heard this week.
Consumer peak body COTA Australia CEO Ian Yates was among the first to present evidence to Royal Commission into Aged Care Quality and Safety which began hearing evidence from witnesses in Adelaide on Monday.
He told the inquiry that residents and their families often feel they are unable to raise complaints with their providers.
“It’s worth noting that there’s a very significant imbalance of power between a resident or a service recipient in high level home care and the provider of that service,” Mr Yates said during questioning by Senior Counsel Assisting Peter Gray.
“They’re in a condition where they feel vulnerable. And where there is absolutely no intention that there might be repercussions from complaining, there will be a natural fear amongst most people about doing that.”
Mr Yates also said access and availability of information about providers and their facilities was among the top priorities of residents and their families when accessing aged care services, but independent information was hard to find.
“When I book a hotel… I can go and read lots of comments on their website about people’s experiences of that. You can’t do that – or very, very rarely with an aged care provider, except selected quotes used for promotional purposes,” he said.
“Not all providers widely advertise how you can make a complaint and don’t necessarily take the time to go through it carefully.
He said COTA is often told that families are asking questions, but not getting responses.
Additional powers for new watchdog
Mr Yates suggests the new independent Aged Care Quality and Safety Commission should be given additional penalty powers, including ban operators from the industry.
“COTA notes that the current suite of penalties (namely a stop on receiving new customers and government funds or revocation of accreditation) does not meet current community expectations for the worst of offences and does not really give the commission an appropriate range of penalties,” he says in his witness statement.
Mr Yates also told the commission there needed to be a focus on employing the right staff into the sector.
“Many of the horror stories that we hear in aged care are committed by people who have qualifications – nursing and other qualifications. I don’t want high ratios of them.
“We have to focus on how we improve the quality of staff, how we make aged care an attractive, desirable career, how we build career pathways into aged care so that people can progress, he said.
Elsewhere at the inquiry, advocacy group for older Australians Combined Pensioners and Superannuants Association policy manager Paul Versteege said staffing ratios need to be addressed.
“We feel that staffing in residential aged care facilities is inadequate and that is a community feeling that there is not enough staff,” Mr Versteege said.
“A facility can determine by itself how many staff they’re going to put on at any given time and that’s borne out by reports from nurses that they’re sometimes looking after 100 or even more people in a nursing home at night,” he said.
Minimum staffing ratios would be a first step in rectifying this issue, Mr Versteege said.
“We could actually mandate that certain types of care require certain levels and skill mixes of staff to deliver adequate care,” he said.
Improving quality of life
Also in the hearing, Mr Versteege proposed an official visitors’ scheme be implemented to the aged care system to improve the quality of life for residents.
“It would basically introduce people who have a fair idea about aged care and who are able to advocate on behalf of residents.
He said about 40 per cent of residents living in aged care never have any visitors because they are isolated or don’t have anyone to visit them.
“An official visitor scheme would be a godsend for those people,” Mr Versteege said.
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