Consumer group releases aged care fix-it list
Consumer advocacy group COTA Australia has released a position paper setting out what it says needs to be done to fix the aged care system as the sector braces for a royal commission.
Consumer advocacy group COTA Australia has released a position paper setting out what it says needs to be done to fix the aged care system as the sector braces for a royal commission.
The paper identifies the key issues in ageing and proposes five recommendations that COTA considers necessary for the future sustainability of the sector.
COTA welcomed the federal government’s recent announcement of the royal commission but has expressed concerns it might delay some of the more urgent reforms.
What consumers want
- funding for 30,000 more high level Home Care Packages to reduce wait times to a maximum of 3 months
- setting a definite date for putting residential aged care places in the hands of consumers
- compulsory publication of aged care services, staffing levels, price and quality performance by mid-2019
- more funding to secure the right quality and mix of aged care staff
- all inspections of providers to be totally unannounced inspections at least once a year
COTA Australia CEO Ian Yates said while the recommendations weren’t breaking any new ground, they would ensure the sector was more responsive to the needs of people in the aged care system.
“What we’re suggesting isn’t new. COTA, and successive government reviews and reports, have identified the changes that need to occur now to restructure the aged care system,” Mr Yates said.
“While the Royal Commission will address major long-term challenges, other things should happen now.”
On home care packages, Mr Yates said many older Australians are being forced into aged care facilities due to extensive wait periods before receiving high quality home care packages.
“Further investment in home care packages is absolutely critical to providing older Australians with the option to stay at home as they age; and take some pressure off funding residential aged care,” he said.
The bed licence system, which allocates beds to providers regardless of quality and performance, should also be removed, Mr Yates said.
“Without this fundamental change there is absolutely no incentive for aged care providers to deliver excellence in care,” he said.
Transparency and accountability
Under current legislation, providers are not obligated to publish information including prices, quality performance and staffing levels.
“There must be both transparency and accountability so that older Australians have clear information they need to choose the service that’s right for them,” Mr Yates said.
While there has also been the recent announcement of an inquiry into the Aged Care Amendment (Staffing Ratio Disclosure) which proposes the quarterly publishing of resident to staff ratios, Mr Yates said there needs to be more funding towards staff to enable the delivery of higher quality care.
He said there are many dedicated aged care staff in the sector however there need to be “more positions … real career pathways, more and better training and much better pay for the bulk of the workforce.”
Mr Yates said totally random visits should occur at least once a year, as current unannounced visits, announced in the 2018 Budget, give providers 90 days notice.
Providers with a high number of complaints should be more targeted to ensure quality of care is provided to residents every day, he said.
Mr Yates said these recommendations cannot wait, and that the Government must make these a priority to fix the aged care system.
“Our aged care system as a whole isn’t up to scratch, and it needs to be.”
Access the paper, Keep fixing Australia’s aged care system… taking the next steps in tandem with the Royal Commission here.
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There should also be random visits to organisations that manage Home Care Packages as the quality of services and accountability in the management of clients packages is not up to the standard that it should be
Ian Yates may not realise it but the Quality Agency has been conducting announced and unannounced visits to aged care services on a risk based profile, with increased visits to places of concern. This may involve multiple visits until concerns are addressed and seen to be sustainable.
As to the annual unannounced visits each provider has one a year. In relation to the three yearly full audit the process is to give notice 90 days out from the due date.This is not telling providers anything new as they will know from their accreditation expiry date when it is due. The main idea from the notice, which does not specify a date, is so that families and residents can provide feedback to the Agency ahead of an audit so that this can be factored in and help direct the audit.
The new format of an unannounced visit is now for the first half to be taken up of consultation with residents and families and then the assessors focus their audit on any issues identified and other key areas.
These system enhancements have been embraced by the industry and the majority of aged care providers welcome this and the audits find that their systems and services are of a high quality and meet the resident needs well.
Is there something new in what Mr Yates is saying? I think not. I feel that if this is the best that COTA , advocating for aged care recipients can come up with then, the Royal Commission is doomed.
With respect Mr Yates, all facilities have unannounced visits at least annually.Its been happening for several years. The dig for the core problems needs to be deeper.
STAFFING
It is all well and good to follow the popular push for staff ratios however, if aged care staff are not enabled to deliver best practice care via comprehensive, upskilling and consistent education then nothing will change.We will continue to hear the cries from the coal face ‘not enough time ‘ ‘not enough staff” and unions will jump in with a politically motivated slamming that has a care factor far removed from the welfare of our aged care recipients..
Education for care workers MUST be removed from the multitude of pop up,gov’t funded,
pay your money and you pass, education providers.
We need more registered nurses in aged care who understand we are NOT dealing with people who come into care to die. We are caring for people with complex co morbidities where every day counts. In a nutshell, you actually DO need to have a strong knowledge base, lead by example and be prepared to be everything to everyone.
EDUCATION
The role of the current care worker in aged care is the equivalent of an enrolled nurse 25yrs ago.Their education must start to be reflective of that and the focus of care removed from task orientation and directed towards resident choice. All the fancy descriptors (consumer directed, holistic, person centred) mean nothing if that is not what is being delivered.
Advocate for care worker education to be placed in the hands of TAFE. Minimum 12mths with at least 4mths practical and professional registration at completion.Far too many people are opting for a certificate 3 in aged care because Centrelink told them they have to do a course.
A royal commission is not going to stop inappropriate people entering the industry, but education might just give the workers the power to stand up
FUNDING.
Aged Care Funding should be about providing care hours to meet resident needs.It doesn’t work that way for many of the large providers. It is all about residents being nothing more than a DIAGNOSIS to attain more funding which goes into the pockets of the providers.
COMMUNITY PACKAGES
The worst thing that has happened at community level is taking away package allocations from providers.The previous system had it’s faults but I do not recall people waiting in excess of 6mths for a high level service in a a large regional catchment. People are now waiting, waiting, waiting and the system is flawed unless a person is prepared, or has an advocate prepare to ring My Aged care (worst system ever invented) every single week.Otherwise you either pay while you wait or go without, deteriorate and end up in a residential facility, lonely, dejected and broken
DO we have an aged care crisis or are we responding to social media furore and sensationalised headlines? Most residential providers are actually doing a fine job.Community providers are bashing their heads up against brick walls whilst doing a fine job.
The inquiry also needs to look at –
1. The excessive negative financial impact retirement villages have on the capital base of retirees and the increased need of the taxpayer to chip in for their aged care costs at a later point in time.
2. With care packages retirement villages are becoming quasi low level aged care facilities. The issue is that retirement villages are controlled under state government laws and there are strong arguments for them to come under commonwealth laws alongside aged care.
Why now after all this time!! too little too late!! we have been aware of an aged care crisis coming for years it was just waiting to happen, it was predicted way back in the early 2000s that we needed to be proactive to manage our vastly increasing aged care population, and now more money on a royal commission millions spent on what!! we all know i’s failed and failing, nobody wants to work in this industry due to poor wages and conditions it’s been told over and over for the last 20 years,carers are nurses doing a nurses job if all carers went on strike the aged care industry would fall apart!! I can tell you now what is needed, without a royal commission, it’s been under the governments table for years and they know it !!!understaffed, underfunded fill in the paperwork to make it look fabulous on the outside,we will take years to rectify the blowout and in the meantime carers still go to work doing a fabulous job on sh@t wages, no education because there’s no government funded opportunities to study aged care for free,its a job of love and empathy,and advocacy so aged care staff are seriously taken advantage of especially the many good ones out there!! hopefully it doesn’t drag on for years, but i’m not holding my breath!!
Age care packages are not the answer, the organisations who manage them take 30% to 50% in fees and charges leaving the rest to purchase services at full cost recovery, clients are forgoing social support and community meals to have personal care and domestic assistance leading to lonely socially isolated people.
Don’t fund Aged Care Packages, fund providers to provide the services people need to live healthy, socially interactive lives in the local community.
My Aged Care has been the worse thing to happen to the Aged Care Sector in Victoria. It used to be local people coming to your home to assess you and help organise the services you need. Now you deal with a call centre who don’t know who you are or where you live in relation to services and who keep saying “just go on line its so easy”(29% of people in Rural Victoria don’t have access to the internet at home. Mainly the elderly)