Funding, COVID and fatigue top the concerns for the next year while the sector’s dedicated workforce is providing hope for many, aged care CEOs tell Australian Ageing Agenda.
To mark the beginning of the 2020-21 financial year, AAA asked the chief executive officers of aged care organisations about the year ahead.
In the first part of this series, CEOs talk about their biggest concerns and hopes for 2020-21.
While the coronavirus pandemic is front of all minds, not surprisingly, so is the ongoing struggle of making ends meet.
The CEO of Presbyterian Aged Care in NSW and ACT, Paul Sadler said the long-term underfunding of the sector was still the most significant challenge.
“Inadequate indexation, which has been a problem for nigh on thirty years, plus the impact of ACFI cuts in 2015-16 are causing untold damage to the provision of residential and home care services in Australia,” Mr Sadler told AAA.
“The pandemic has added another layer of uncertainty, both through additional direct costs and the broader economic damage it has wrought. If there is not a systemic funding fix shortly, more and more organisations and the services they provide will close.”
Mr Sadler “holds out hope” the aged care royal commission will follow through on hints that the Australian aged care sector needs 50-100 per cent more funding than it currently has.
However, Mr Sadler said the resilience of those working and volunteering in aged care provides him the most hope for the year. “Lots of people care deeply about looking after older people and no amount of underfunding, or threat from COVID-19, will stop that.”
Industry needs a lifeline
Similarly, Feros Care CEO Jennene Buckley, named the financial pressures as the top concern. She said the StewartBrown reports clearly articulate the sector’s growing financial struggles and COVID-19 has just compounded these pressures.
“The industry is moving into the 2020-21 year still in a pandemic with a possible situation of no ongoing financial relief from government and no royal commission outcome until 2021.
“The industry needs to be thrown a lifeline or I am concerned the 2020-21 year is going to be very bleak for many providers in the industry,” Ms Buckley told AAA.
Doubt over whether the royal commission will be able to deliver a final report this year adds to Buckley’s concerns but the royal commission’s work with aged care stakeholders to find the solutions needed also brings her hope.
“This includes determining what funding model would make us sustainable, what governance system would work best for the sector, as well as what changes need to be implemented,” Ms Buckley said.
“[I]t is important that the industry responds to these consultation papers on governance and financing aged care to ensure there is a balanced and comprehensive view of what will make the industry sustainable in the long term,” she said.
Ms Buckley is also buoyed by the resilience of people who work in aged care and is proud of their passion and dedication despite public negative portrayals of the sector.
“Our workforce continues to hold their heads high and they work tirelessly to provide outstanding care and support. They meet the challenge of additional compliance and regulation, additional workload pressures, funding pressures and still find room for innovation, ideation and creativity.
Aged care workers want to deliver world class services and they need the government to have the same vision, Ms Buckley said. “With the right systems, funding and government support, which is what we hope to see out of the royal commission, there will be nothing stopping us.”
States must resolve COVID clinical pathway impasse
The current pandemic tops the list for Opal Aged Care CEO Rachel Argaman, who saidthe continuing presence of COVID-19, and the recent spike in Victoria, was rightly cause for concern and vigilance in residential aged care.
“It is also important that the states resolve their impasse over the correct clinical pathway and protocol for residents living in aged care who test positive for COVID-19,” Ms Argaman told AAA.
“This is a new virus, a global pandemic and there is no vaccine. The world is still unpacking how it is best managed and world class health systems have buckled under this virus.”
She said residential aged care’s homelike environment was not designed like a hospital with isolation units and specialist teams.
“It seems to us it is better to manage outbreaks in aged care environments by separating those who are positive from those who are negative. This enables us to contain the outbreak and ensure the right specialist care for those with the virus,” Ms Argaman said.
She said a standardised process was particularly important when caring for aged care residents, who are the most vulnerable to COVID-19.
And it is the importance and purpose of caring for this population that brings Ms Argaman the most hope for the year ahead. Giving care, comfort and the human connection is rewarding and meaningful, she said.
“In times like these I think all of us reflect on what matters most. And the answer, for the vast majority of us, is that people matter. So caring for people and working to ensure that we are building thriving communities, hallmarked by love, purpose and a sense of belonging, grounds us in the magic of meaningful work.”
Risk of fatigue
Going into the new financial year, “the main risk is fatigue,” said Chris Stewart, CEO of south Australian provider Helping Hand Aged Care.
“People’s lives have been upended and they’ve had to continue coming to work. In the health and care industries it has been intense. I am really worried about people’s general mental health and wellness with the constant pressure, grief, uncertainty and ambiguity,” Mr Stewart told AAA.
To address this, Helping Hand has spent a lot of time and effort on staff wellbeing and it has paid off, he said.
“We have trained 12-15 mental health first aiders who are accredited so they can provide counselling and support within our teams. The organisation has put in place a range of measures to support staff from flexible paid leave to extensive internal communications systems.”
Mr Stewart said they must also be prepared to see coronavirus come back into the state, which adds to those concerns for fatigue. “If people need to lift again to manage another wave, it is draining on staff.”
However, he said one of the things that has shone through in this time of crisis is how good Helping Hand’s people are. “If you look after your staff, they pay you back 10-fold, and that’s what is great to see happen at Helping Hand.”
Time for a national conversation on ageing
The top concern for Bolton Clarke CEO Stephen Muggleton is older people getting equal access to the care and support they need.
“This is best reflected in underfunding of residential aged care and in the lengthy waiting time and associated mortality rate associated with the home care package queue,” Mr Muggleton told AAA.
He is calling for a national conversation on ageing underpinned by a Cabinet portfolio covering key issues including housing, integration with the hospital system and supports that help people age in place.
Like many of his counterparts, Mr Muggleton’s source of hope is the workforce and particularly “the courage, determination and commitment of our frontline staff,” he said.
“Their unwavering commitment through natural disasters and COVID-19 in an environment characterised by over regulation and underfunding is nothing short of heroic.
“Their efforts serve as motivation to us all to continue fighting for the increased funding for the sector so we can reward those who choose to spend their working lives caring for the most frail and vulnerable of Australians,” he said.
Concern over access to adequate resources
Making ends meet is also top of mind for Sandra Hills, CEO of Victorian provider Benetas.
“With heightened discussions on our sector’s financial sustainability, I’m most concerned about our sector’s access to the adequate resources that will support us to meet the increased compliance requirements we now face with COVID-19,” Ms Hills told AAA.
“The last four months have also shone a light on the need for aged care take its rightful place as an essential part of our healthcare system. Stronger and clearer coordination between aged care and the wider healthcare system is going to be vital if we’re to provide older Australians with the care that they need.
Amidst the adversity, Ms Hills said the incredible acts of kindness and generosity she’s witnessed towards older people in the community give her hope.
“Many of our employees, families, carers and the wider community have gone above and beyond to support one another and protect those most vulnerable to the disease. Not only do I hope that at Benetas we can continue to harness the incredible dedication that we see across our colleagues and teams, but I also hope that as a community we’re able to break down the entrenched ageism that we see across our society and health systems,” she said.
Like some of her counterparts, Ms Hills is “incredibly hopeful” the aged care royal commission will help chart a positive way forward for the sector and aged care recipients.
“With its final report due this November, I certainly hope that its recommendations help steer us towards a more sustainable future.”
Read next: CEOs discuss strategic plans for 2020-21
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