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One year on from the Aged Care Royal Commission’s Final Report

It has been a full year since the Royal Commission into Aged Care Quality and Safety handed down its Final Report into the systemic issues plaguing the Australian aged care system.

<p>In late February, the Aged Care Royal Commission handed its Final Report to the Government, which was tabled into Parliament on 1 March, 2021. [Source: Shutterstock]</p>

In late February, the Aged Care Royal Commission handed its Final Report to the Government, which was tabled into Parliament on 1 March, 2021. [Source: Shutterstock]

This Final Report helped form the current Federal Government’s five year, five pillar plan to deliver respect, care and dignity to all older Australians accessing Government funded aged care services.

Minister for Health and Aged Care, Greg Hunt, says that the Royal Commission resulted in a lot of change in the sector and that the Government is currently in the process of rolling out new reforms.

“We responded to the recommendations and are now implementing this once-in-a-generation reform that puts senior Australians first,” says Minister Hunt.

“Our financial commitment is now more than $18.3 billion to fund this agenda for change across home care, residential care, quality and safety, workforce and governance.”

The five year, five pillar aged care reform plan incorporates all 148 recommendations suggested by the Royal Commissioners to achieve quality aged care for older Australians.

Recently, the National Aged Care Advisory Group and Council of Elders was established, which was a big step towards ensuring tangible outcomes and supporting the implementation of necessary aged care reforms.

“The continued implementation of the reforms is now guided by these two important groups of representatives to ensure each measure that is introduced continues to meet the needs and expectations of senior Australians, families, carers and the wider community,” says Minister Hunt.

“To make access to aged care services easier to navigate, we have begun rolling out in-person help at many Services Australia centres, local care finders, a regional network pilot, and aligned with a program to better connect culturally and linguistically diverse seniors, families and carers.”

So far, over 33,000 extra training places have been developed to encourage people into working in the aged care sector, and an additional 191 registered nurses have entered the workforce through the Aged Care Transition to Practice Program.

There have been 115 scholarships awarded to aged care nurses who wanted to increase their knowledge and skills.

Registered nurses have also been encouraged to stay in the sector through the Aged Care Registered Nurses’ Payment, and rural and remote area nurses will receive an additional annual payment on top of their normal wage.

Minister for Senior Australians and Aged Care services, Richard Colbeck, says the first year of the five year, five pillar plan was focused on boosting Home Care Packages.

“We recognise that most Australians want to stay in their own home as they get older, and Home Care Packages make that possible,” says Minister Colbeck.

“At the end of 2021, 217,724 senior Australians had access to a Home Care Package – that’s up 25 percent since the end of 2020, thanks to the rollout of the first of the 80,000 packages announced in response to the Royal Commission.

“In the same period, [those on] the priority waiting list has come down by 29 percent and for those assessed as a high priority receiving a package within a month.

“There is greater transparency in home care funding, with the Government paying providers monthly – which means the maximum amount of package funds go towards a person’s support. Residential aged care providers are also receiving extra funding of $10 per resident per day to improve care and services, especially food and nutrition, and must report care staffing minutes to make sure senior Australians get appropriate care.”

The Serious Incident Reporting Scheme, electronic medication charts, improved quality indicators, and “last resort” restrictive practices use was also recently introduced.

Just over $100 million of funding through the Business Improvement Fund was provided to nearly 200 residential aged care facilities to assist with their financial viability.

Further reform for the sector is currently going before Parliament, including:

  • Introduction of the new funding model for the sector, the Australian National Aged Care Classification (AN-ACC), which is expected to be introduced from October 1, 2022. It will include a funding boost to improve front line care to residents and deliver increased funding to rural and remote residential aged care services (including specialised homeless and remote Indigenous services)
  • An aged care worker registration scheme, which would be for pre-employment screening and to replace police check obligations
  • Expansion of the Serious Incident Response Scheme to home and flexible care from July 1, 2022

The next stage of reform has begun, which includes drafting the new legislation for the Aged Care Act, quality of life indicators, a new support at home program, dementia friendly accommodation design, and dementia education and training.

To see what reform is up next, visit the Aged Care Engagement Hub on the Health Department website or call 1800 200 422.

Industry wants political commitments ahead of Federal Election

Following the one year anniversary of the Royal Commission’s Final Report, aged care sector peak bodies are looking for industry commitments ahead of the upcoming Federal Election.

The Australian Aged Care Collaboration (AACC), an alliance of six aged care peak bodies, says that the sector has welcomed the response to the Final Report in the Budget of 2021, however, the organisation believes there is still much more work to be done to fix key issues in aged care including the ongoing issues with the workforce.

Spokesperson for the AACC and Chief Executive Officer (CEO) of Leading Age Services Australia (LASA), Sean Rooney, says adequate staffing with an appropriate skills and qualifications mix is really important for the sector.

“This means we need more staff who are adequately skilled and qualified, and paid appropriately. We need this to be prioritised by Government so we are supported to deal with the pandemic, whilst also realising the intent of the Royal Commission reforms,” says Mr Rooney.

“We need the Government to step up and commit to funding a pay rise for aged care staff and to put resources into recruitment and retention of staff as well as training. Current funding levels mean that most providers are unable to do this.

“Without immediate changes to better support the workforce, the aged care sector will be unable to recover from the current crisis. This will further impact the ability of providers to consistently meet the needs of the older Australians they care for.

“It’s time to make sure, once and for all, that older Australians get the care they deserve. This means adequately resourcing and enabling the staff and services that care for and support them.”

The AACC is calling for commitments on:

  • A Workforce Partnership Supplement for providers to spend immediately on increasing wages, training, minutes of care, 24-hour nursing and COVID-19 prevention and workforce retention costs
  • A minimum wage increase for aged care workers by funding the Fair Work Commission Work Value Case with increases starting from July 2022
  • A multidisciplinary workforce

Paul Sadler, CEO of Aged and Community Services Australia (ACSA), says that the COVID-19 pandemic and the Royal Commission Final Report has been transformative for the aged care sector, however, the pandemic really exposed the lack of resilience in the aged care sector.

Since the Final Report was released, he says there has been a huge shift to the sector that will continue over the coming year, but the recent COVID-19 resurgence has highlighted the critical workforce shortages.

“As we enter the third year of the COVID pandemic, it’s important to note the challenges of aged care sector reform as highlighted in the Royal Commission and its recommendations have not gone away,” says Mr Sadler.

“The pressure of an ageing population with higher expectations for their older years has not changed. The need for innovation and new models for providing support for older people has not gone away.

“The Government response to the Royal Commission evaded two key areas: paying aged care workers what they are worth; and how high quality aged care is to be financed into the future.

“Action on Royal Commission recommended reform is critical and the opportunity for lasting, systemic change must not be kicked down the road by Government or lost altogether.

“All parties need to commit to funding the outcome of the Fair Work Commission aged care work value case. And all parties must ensure aged care is funded properly and sustainably so we can provide high quality services.”

Consumer body highlights areas to be improved upon

Peak body for older people, National Seniors Australia, has also released a report on what older Australians want in aged care on the eve of the first anniversary of the Royal Commission findings.

The report, As close to home as possible, found that older Australians are wanting and searching for residential aged care facilities that feel like a home rather than an institution.

Professor John McCallum, Chief Executive and Director of Research at National Seniors, says that the survey participants want home cooked meals and accommodation in a home-like aged care facility that caters for individual needs.

“The Royal Commission and the media coverage have had a major impact on older Australians’ attitudes toward residential aged care,” says Professor McCallum.

“Many of those people who responded are worried they will suffer the same neglect and abuse they have heard and read about in evidence tabled at the Royal Commission.

“However, they say one way to combat this fear is for more smaller, community minded facilities with home-like features.”

Professor McCallum adds that other issues older Australians face with residential aged care include issues with navigating information when searching for the right nursing home.

While the Federal Government has tried to update their process for navigating aged care, survey participants say they want a “one-stop-shop” when it comes to searching for aged care and that aged care information should be provided in an easy to understand way.

The five areas identified in the National Seniors survey that need to be improved on are:

  • Information about specific facilities
  • Effective communication
  • Guidance to improve navigation of the aged care system
  • Professional services to protect the welfare of care seekers
  • Public communication on aged care planning

Survey participants were also concerned about the focus on money from facilities, aged care facility fees, and the rising cost of aged care.

“A lot [of survey participants] told us they saw profit and quality care as being incompatible even though there are plenty of for-profit homes which do a great job in looking after their residents,” says Professor McCallum.

“Conversely we have seen in the Royal Commission some not for profit homes which have let their residents down.”

Other areas that survey participants want to see improved include:

  • Increased staff numbers and better pay
  • Diverse housing models
  • More opportunities to socialise for residents
  • Greater accountability to prevent elder abuse

To read the full report, visit the National Seniors Australia website.

Re-doubling reform efforts

The aged care advocacy peak body, Older Persons Advocacy Network (OPAN), is urging policymakers to ramp up their reform efforts heading into the second year of the Government’s reform plan.

CEO of OPAN, Craig Gear, agrees with other peak bodies that a lot has changed in the last 12 months, however, says there is still more work to be done in the aged care sector.

He explains the $18 billion commitment from the Government was a huge win for the sector, and there was the establishment of the Council of Elders and the National Aged Care Advisory council which has been a positive step forward for older peoples’ voices.

“Older people have been telling us for a long time that there should be ‘nothing about us without us’ and the Council is a good step along the journey to drive more inclusive, dignified and respectful care,” says Mr Gear.

“The new National Aged Care Advisory Council is also now up and running and there’s been a boost to advocacy funding which is giving a voice to thousands of older Australians.

“These are really positive developments, but we need to redouble the reform effort.”

OPAN is urging the Government to ensure that the new Aged Care Act embeds older people’s rights at its core.

“Make no mistake, there will be resistance to full and practical application of a rights-based Act by vested interests – but these reforms are designed for older Australians, not providers or even families who will need to find a path through,” explains Mr Gear.

Additionally, OPAN wants more transparency around funding and staffing levels, which will recognise and appropriately pay the aged care workforce, as well as help address abuse against older people.

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