Australia’s aged care sector needs reform

The Federal Government recognises this in the preamble to yet another review called the Single Aged Care Quality Framework.

The Government says it will focus on consumers and “considers the health, safety and welfare of aged care recipients a high priority”.

The need to fix things is reflected in myriad reviews and inquiries in progress. They include a Senate inquiry, as well as state and Commonwealth investigations into the abuse at the Oakden facility. The ICAC is now also investigating SA Health for maladministration.

The Single Aged Care Quality Framework will be piloted and become law from July 2018.

There are also other reviews proposing new aged care quality standards and options for streamlining accreditation processes. This single quality standard approach will cover both home care and residential care.

National Seniors has been part of the consultation process and we are pleased to see a number of indicators in the proposed standards. The draft standards require providers to have processes in place to identify consumers’ needs and deliver aged care to meet them.

Those needs could vary from wanting different food to more physio. But how will the process standards operate in practice? They don’t measure the outcome experienced by a consumer. They simply insist a provider has a certain process in place. The shift to process standards will not improve outcomes for consumers without adequate resourcing. What is required is sufficient and appropriately skilled staff.

The latest figures show the proportion of workers engaged in direct care has declined from 76 per cent in 2007 to only 65 per cent in 2016. Nurses now account for 25 per cent of direct care staff, whereas the share of personal care workers increased to 70 per cent.

National Seniors is sceptical about the capacity of providers, under the current funding and regulatory arrangements, to meet the proposed new standards and improve outcomes for consumers. Changes to standards alone won’t drive improvements in quality.

National Seniors is calling for effective checks and balances to monitor the everyday outcomes experienced by consumers. Unannounced visits by accreditation officers are possible in aged care facilities, but we know from our members these are not being used effectively. For example, unannounced inspections do not occur at night when there is limited staff on duty.

Given the new standards require more intensive processes to understand and act on consumers’ needs, we worry the resource limitations may undermine quality outcomes.

Another key issue is how the most vulnerable and voiceless, such as a person with dementia, will be able to adequately direct their care? This can be done through the family. But what if you have no family?

Once again, it may come down to how much money as a society we are prepared to spend.

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Australia’s aged care sector needs reform

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