Aged care stakeholders tell inquiry how to improve services

Recent submissions are calling for a shake-up of aged care for Stolen Generations, research into effective staff-to-resident ratios and a regulatory framework that better supports provider viability.

The Government needs to review assessment processes, develop an indigenous workforce strategy and urgently fund trusted organisations to expand their capacity to support ageing Stolen Generations to access aged care, advocates have told the royal commission.

The Australian Association of Gerontology’s Aboriginal and Torres Strait Islander Ageing Advisory Group and the Healing Foundation, a national Aboriginal and Torres Strait Islander organisation that partners with communities to address the ongoing trauma caused by past actions, recently made a joint submission to the Royal Commission into Aged Care Quality and Safety.

Stolen Generations experience fear and anxiety, low awareness about services and assessment pathways and re-traumatisation when they access aged care services, the submission highlights.

They are likely to be worse off than other Aboriginal and Torres Strait Islander people of the same age and socioeconomic outcomes, it said (read more here).

Five of the seven recommendations in the submission were formed at ATSIAAG’s Stolen Generations Aged Care Forum in Melbourne in June this year.

Recommendations include:

  • urgent Commonwealth funding for trusted Stolen Generation organisations to expand their capacity to support ageing Stolen Generations and their families to access aged care and wrap around services
  • a review of aged care assessment process for Stolen Generations
  • the development of an Aboriginal workforce development strategy to being implemented throughout the aged care sector.

Doctors call for research on effective staffing levels

Doctors’ peak body the Australian Medical Association is calling for research to ascertain best-practice staff-to-resident ratios in residential care and funding to increase the number of doctors visiting facilities among 42 recommendations made to the inquiry.

“There needs to be independent research and modelling into the most effective minimum staffing ratio, in consultation with all stakeholders. Currently, there is limited research into staffing ratios for residential aged care facilities in Australia,” AMA’s submission said.

Once understood, minimum mandatory staff-to-resident ratios that reflect the level of care of residents and ensure a 24 hour on-site registered nurse should then be introduced, the AMA said.

The AMA acknowledged the Queensland Government’s introduction of mandated staff ratios and a requirement of at least 3.65 hours of contact in its 16 state-owned aged care facilities (read more here).

The AMA said it did now know the formula these requirements were based on but provided in principle support to the Queensland Government’s decision.

“The AMA acknowledges that adequate staffing ratios alone might not ensure quality in all aspects, but inadequate staffing certainly prevents it,” the AMA said.

The AMA is also calling for funding to increase the number of doctors working in facilities. Getting It said getting more doctors interested in working in aged care should be the focus of future reforms to ensure the provision of appropriate clinical care.

“Investing in primary care particularly for patients in aged care settings will save on public hospital expenditures,” the AMA said.

Consultant says changes to rules and regulations will improve provider viability

Aged care consultancy Pride Living has told the inquiry to revamp the accommodation supplement and regulations around specified and additional services and accommodation payment options to improve provider viability.

Bruce Bailey

Pride Living director Bruce Bailey said provider viability and sustainability were key drivers of quality and safety for residents in aged care.

“Increasing provider viability allows providers to invest in the systems, processes, training and staff to enhance the safety and quality of care provided to consumers,” he said in the submission.

Pride Living’s recommendations include:

  • setting the accommodation supplement relative to average capital cost of a residential place to increase return on investment and boost investment in new accommodation for supported residents
  • removing the subsidy reduction where supported ratio is less than the arbitrary 40 per cent and apply the reduction where the supported ratio falls below the local supported ratio to allow providers to draw higher accommodation charges and additional services revenue from more residents
  • setting policy to actively facilitate and encourage a greater adoption of additional services
  • allowing providers to offer a refundable accommodation deposit (RAD) or daily accommodation payment (DAP) as they choose rather than the current system where a resident chooses.

Nurses call for minimum staffing levels and skills mix

Elsewhere, nurses’ union the Australian Nursing and Midwifery Federation reiterated calls for mandated minimum staffing levels and skills and improved financial reporting and transparency in one of its six submission to the inquiry to date.

The ANMF’s submissions on improving the aged care regulatory framework focuses on how key legislation and regulation affects service provision.

The ANMF’s submission draws on the royal commission July case study of Bertha Aalberts and said the care she received was “a clear example of the failings of the regulatory regime for residential aged care.”

The ANMF is calling for system where all standards, regulations and legislation operate under a premise that ensures the provision of safe and quality aged care that protects the public from the risk of harm.

“The assessment of any legislation, regulation or standard must be viewed through the lens of the quality of the care received by the individual,” the ANMF said.

Researchers call for ongoing investment in studies

Elsewhere, the editors of the Australasian Journal on Ageing are calling for ongoing investment in research and best practice implementation to support the delivery of quality and safe aged care services.

The submission consists of three virtual issues of the publication containing more than 50 previously published aged care research studies addressing topics in the royal commission’s terms of reference.

Studies featured include:

  • the language needs of residents from linguistically diverse backgrounds
  • care staff attitudes and experiences of working with older people with dementia
  • disease burden, comorbidity and geriatric syndromes in the Australian aged care population

“The breadth and depth of research on ageing in Australia provides a strong case for continued investment in both research and best practice implementation that will support aged care services being delivered in a way that provides efficient and effective outcomes for older Australians,” said AJA editor Professor Lynne Parkinson and deputy editor Dr Jane Sims.

Submission deadline extended

The Royal Commission into Aged Care Quality and Safety has received 6,404 submissions to date.

The commission has also extended the deadline to make submissions until end of April 2020 ahead of its final reporting date of 12 November 2020.

View the full submissions for ATSIAAG and the Healing Foundation, AMA, Pride Living, ANMF and the Australasian Journal on Ageing.

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Tags: aag, Aboriginal and Torres Strait Islander Ageing Advisory Group, aged-care-royal-commission, ama, anmf, ATSIAAG, australasian-journal-on-ageing, Australian Nursing and Midwifery Foundation, australian-association-of-gerontology, australian-medical-association, Bruce Bailey, Dr Jane Sims, news-4, pride-living, Professor Lynne Parkinson, royal commission into aged care quality and safety, Stolen Generations, the healing foundation,

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