Additional money will help bring improvements but more elements are needed to achieve a five-star aged care system, writes Mark Sheldon-Stemm.

Recommendations to the Royal Commission into Aged Care Quality and Safety proposed that more money needs to be provided for aged care to become a five-star service. The amount needed is estimated at $15 to $30 billion as either one-off or recurrent funding.

However, will this address the major issues that have been found by the royal commission?

From reading the submissions, testimonies and in particular those referenced in the proposed recommendations, there are three main themes that stand out:

  • abuse
  • neglect
  • waiting for services.

Will money fix these things?

Abuse

The abuse reported and demonstrated is a product of culture rather than money. Those involved have been shown to have poor leadership from the board and senior and middle management, which is then reflected in staff’s treatment of the elderly.

This is an attitude and no amount of money will change this or those involved. The proposed recommendations have addressed this through tighter regulations and the ability for the aggrieved to take civil action against those they see responsible.

Mark Sheldon-Stemm

Neglect

This also follows on from the above and is the silent form of abuse. Many have pointed to the fact that neglect has been driven by the lack of staff available to attend the needs of the elderly and therefore more money is needed. The proposed recommendations look at addressing this through minimum staffing levels in residential care. This requires more money and is estimated to cost from $ 750 million to $1 billion a year of recurrent funding.

Will this avoid any neglect from occurring? Probably not.

Neglect is a mixture of attitude and resources. More resources are required but it is quality rather than quantity that is needed. Getting the mix right is the key to success.

Waiting for services

The rationing of aged care services has been highlighted during the inquiry and it is also reflected in the proposed recommendation that services are no longer rationed. The estimated cost of this would be approximately $2.5 billion a year in recurrent funding and it would eliminate the waiting list for home care.

In residential care, there are already approximately 20 per cent of the allocated beds still not built and occupancy levels are dropping year on year in response to the push to keep people at home and provide services there.

Attitude, leadership, dedication

There is more money required to achieve a five-star aged care system, which includes unrationed services, an increase in some staffing levels and addressing the indexation issues that have produced a 70-per-cent efficiency in aged care over the past 23 years.

But like the expensive restaurants and resorts, money does not always drive service. Only service that provides customer satisfaction. And hopefully it will eliminate abuse and neglect that occurs in aged care.

More money will provide a base for improvements but in the end, it is the attitude, leadership, and dedication in providing services that will deliver a five-star system. Having this new attitude to providing aged care services is the challenge for providers and our society in general.

Mark Sheldon-Stemm is principal at Research Analytics.

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5 Comments

  1. It’s not like the residential sector is looking for “more money”. They are in need of the funding that was in place up until 2015. The federal government and its then treasurer initiated cuts that significantly reduced the funding per resident per day and if you think about it for just a second you will quickly realise that is when the wheels started to fall off the wagon. You can’t take away the funding and not expect things to deteriorate as a result. Facilities have generally done a fantastic job just to stay open, employ and care for thousands of vulnerable residents.
    The federal government has failed its duty of care to provide adequate funding for the provision of safe and sustainable care for vulnerable residents.

  2. The inability to pay care staff a decent hourly rate for the work they do effects the quality of staff we can recruit.
    Younger generations are not choosing aged care as a career path! Why? Because the money is poor, the hours are not nine to five the work is hard and sometimes confronting. Let’s face it, you need to be a special kind of person to work in aged care, you have to love it. These staff are required to leave there family to come and look after someone else’s loved one. We miss out on special occasions, Christmas day etc etc.
    My point being, a person earns more by stocking shelves at a supermarket then what they do in Aged Care!
    The difference being, We reward people more for putting a can of beans on a shelf than we do a person that assists a human to live there best life, to deal with incontinence, meal assist, showering and personal hygiene. To build a rapport with them, and to hold there hand whilst they pass away all the while holding back there own tears!! Then they pick themselves up to walk into the room next door and put a smile on there face and meet the needs of the next resident.
    We have it all very wrong – Let’s put the money where it is needed and where it is deserved.

  3. I’m sorry but there’s a glaring omission that can be solved by more funding/money – the quality of staff.

    Aged care just doesn’t generally attract higher quality & more qualified workers because the wages don’t compete with the hospital system.
    Even with a global pandemic insufficient numbers of workers, including those from an English speaking background, are pivoting from other industries as they’re losing jobs. – despite some efforts by the government.

    Pre-COVID there was already an issue with not enough staff from an English-speaking background. Not that they are all bad but you can see the quality of care affecting residents in Australian RACFs (who have grown up in the 1930s, 40s, 50s & 60s) because a number of the international workers see aged care as just another job – clock in, clock out, do the bare minimum. Hours & $$$ of training are thrown at aged care workers to try & bridge the gap between 20-year olds from another country & our elderly, but it is largely not working as the training is just another box seen by them to tick.
    I am sick of seeing untrained inconsiderate kitchen staff plonking meals in front of residents and when they’re asked by the resident what the meal is, receiving one word answers

    The Aged Care wages need a boost and the industry needs a PR kick up the backside. The industry needs to attract more school leavers & university graduates from our own shores, not source cheaper labour overseas.

    Also, the bill for greater transparency with provider profits needs to go through and corporate bodies need to show where all the money is going.

    Our elderly deserve better.

  4. I tend to agree with the above comments about wages, sometimes if you do pay peanuts you get monkeys,. Even with a Cert 3 done in record time or the longer course, it doesn’t mean you will get great staff. The culture and leadership also needs to come from the Registered Nurses or Care Managers, as these days the Facility Manager is snowed under with paper, emails and phones. If the Leaders out on the floor are pushing good care then the others will follow, but again many of these great Nurses are lost to the Hospitals who are all expanding and wanting the high caliber staff, and they pay well. Young Nurses coming out of Uni have bills to pay. I hope that we see a rise in wages in aged care so as to compete for the best staff.

  5. Thank you for your comments and I am glad it generated some views on this. Having developed a system that works entirely on relationships in aged care then the question of pay rates and getting the right people is an interesting one. I think the question that needs to be answered is – What is a fair wage for what carers do in aged care and how does this align to the attitude they have with their role? There will always be people who are only there for the money and don’t care and there needs to be less of them. Paying more money will reward those genuine people but will it attract more of them? Aged Care is 70% heart and 30% head so the mixture of money and motivation needs to be right. Not an easy issue to resolve.

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