There is a lack of quality leadership in residential aged care, according to a new industry benchmarking report.

The QPS Benchmarking Residential Aged Care Performance Report 2020, which was released on 20 August, draws on data from 13,714 residents, 11,645 relatives and 19,655 employees to explore the clinical governance of residential aged care in Australia.

The report recommends a focus on strategic leadership based on the needs and rights of consumers, investment in education to navigate the complex and dynamic regulatory environment and clear career pathways and succession planning.

QPS Benchmarking principal Silvia Holcroft said the key leadership and governance findings include a lack in quality leadership in residential aged care, and an external regulatory environment that imposes the clinical standards expected for care and service provision.

“The interpretation and application of these standards relies on the knowledge and skills of the leaders,” Ms Holcroft told Australian Ageing Agenda.

Silvia Holcroft

To support knowledge and skills acquisition, there is a need for nationally consistent whole of business clinical performance information, she said.

Ms Holcroft said the key clinical workforce findings include that employees are the foundation of residential aged care and therefore determine the safety and quality of care in facilities.

“Clinical outcomes rely on workforce capacity and must be evidenced based. A skilled and sustainable workforce is needed to ensure high quality and safe care and services provision,” she said.

“Increased investment in education and training is needed for all designations of staff,” Ms Holcroft said.

Causes of leadership issues

The report highlights a range of stressors impacting the sector including internal stressors such as the changing expectations of residents and their families, an inability to attract the workforce and increasing staff turnover.

External stresses include changes to regulatory and compliance structures and powers of the quality regulator, the aged care royal commission, funding and negative media coverage.

“[Leadership] improvement will come when funding is increased and the external stressors on leaders are reduced,” Ms Holcroft said.

Leadership impacts quality

Ms Holcroft said effective leadership promoted and supported a culture focused on the consumer, and the delivery of safe and quality care and services.

“Good leadership engenders trust by consumers’ and managers’ capabilities. Trust is a core ingredient in developing the workplace values and culture to deliver safe, quality care and services,” she said.

However, the report found a lack of trust from consumers also due to the royal commission and negative media representations plus perceptions of an under skilled workforce and low visibility of management.

Ms Holcroft said the sector’s stressors could also be influencing consumer trust.

“Staffing is always an issue and the external stressors feed the internal stressors. For example, the media runs a bad news story and then internal complaints related to the content of that story escalate.”

More support for leadership and more education for residents and their families to combat negative media could reduce these stressors, she said.

“Leaders require mentoring and support as their role is complex and regulatory requirements are also complex.”

Recommendations

The report calls for a range of measures to improve governance, consumer facing employee capability, employee relations, leadership, clinical experience and consumer experience.

They include:

  • support for risk management through validated benchmarking and risk assessment tools to protect business from civil and compliance issues
  • an increase in the minimum entry level qualification for care workers to a Certificate IV
  • enhanced employee assistance programs to mitigate negative workplace cultures
  • an investment in targeted accredited education for leadership and mentoring for existing leaders
  • enhanced access to evidence-based clinical practice information
  • continued work to build a collaborative approach to clinical care.

Access the report here.

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