Aged care in Australia appears to be heading toward the same risk-averse culture that exists in England, warns a visiting aged care executive.
Ed Russell, who is director of innovation and development at not-for-profit residential aged care provider WCS Care in Warwickshire, England, said care scandals in the UK a couple of years ago have led to a risk-averse culture among both providers and quality inspectors.
“Just hearing the conversations here, it sounds and feels familiar and I am worried about the repercussions,” Mr Russell told Australian Ageing Agenda.
“What really concerns me and it should be on everybody’s radar is doing things for the regulator because they are scary and hold so much power rather than for the people who you are caring for.”
AAA met with Mr Russell in Sydney last month when he was a guest of HammondCare as part of a partnership the two aged care providers have to share learnings.
The situation in England today is very risk averse and regulatory driven, which is stifling innovation, Mr Russell said.
After facilities were involved in scandals shortly after a positive inspection, regulators became more risk averse because it was riskier to give someone a good or an outstanding rating than a bad one, he said.
The Care Quality Commission, which is the independent regulator of health and social care in England, rates facilities as outstanding, good, requires improvement or inadequate.
“For a regulator to give you a good or outstanding rating it is pretty tough because of their own risk of being caught out that the next day if something not very good happens. So for a care home provider to achieve outstanding it becomes unobtainable and therefore nobody is driven to improve services,” he said.
“The impact on care homes is that care workers feel devalued and under pressure. They are not paid much above the minimum wage. Care home managers caught in the middle are suffering from a punitive management style because everybody is covering themselves down the line. Therefore innovation [and] doing things differently is not out there.”
WCS Care came to recognition when half of its 12 care homes achieved an outstanding rating, said Mr Russell.
“That is not because we did it for the regulator, we did stuff because it was the right thing to do. Generally the two align,” he said.
WCS Care has implemented a range of new technologies and approaches in its facilities aimed at improving residents’ quality of care and life including acoustic night time listening and circadian lighting.
Mr Russell said the people at the top of the UK regulator say they want care providers to be innovative, however that message is slow to get through to inspectors.
He said having case studies that demonstrated the positive impact the service had on resident outcomes were key to the inspection and assessment process.
Mr Russell’s advice to Australian aged care regulators and assessors is to focus on resident outcomes as the most important element.
When the regulation is a lighter touch and focusing on outcomes for people, it’s good for innovation, he said.
Director of HammondCare’s Dementia Centre, Associate Professor Colm Cunningham said it was important that providers were able to safely and freely share both positive and negative learnings.
“If we talk about doing the real stuff – what we did, what we learnt, what we made mistakes about and what we might do differently – we will learn from each other.
“But the point is … if you drive fear, nobody will talk to anybody. Then nobody will learn anything,” Associate Professor Cunningham told AAA.
See the upcoming May-June edition of Australian Ageing Agenda magazine for a report on WCS Care’s use of acoustic night time listening and other innovative technologies.
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