The Tasmanian hearing of the Royal Commission into Aged Care concluded last month with suggestions as to how better governance and leadership could help to stop some of the sector’s bad practices – which which were slammed in the Commission’s scathing interim report.
Counsel assisting, Peter Rozen, referred to stories of staff- and cost-cutting, saying the results were key problems: “insufficient time for care, deficient organisational culture, insufficient attention to quality clinical care, facilities’ poor communication and a lack of response to complaints”. He outlined four areas demanding better attention.
Firstly, Rozen said the hearings’ evidence seriously questioned if any balance is being struck between duties such as safety and care, and making profit. He suggested introducing statutory responsibilities to stay informed about quality of care for all people charged with governing aged care providers and for providers’ own board members.
A second key area for improvement was the organisational structure of governance and clinical governance. Witnesses told the commission that the banking Royal Commission’s guidelines for good practice could also be a good guide for the aged care sector, when banking guidelines advised, “Obey the law, do not mislead or deceive, be fair, provide services that are fit for purpose, deliver services with reasonable care and skill, and when acting for another, act in the best interests of that other.”
Thirdly, increased accountability and more engagement from management was vital for good culture. Rozen quoted a witness who said: “A leader who sits behind a desk trying to lead a care home from there will inevitably have a culture that isn’t accountable out on the floor.”
Lastly Rozen asked how a funding environment can be created that does not draw resources away from direct care. The Aged Care Funding Instrument, which allocates resources according to its assessment of core care needs, and focuses on day-to-day, high-frequency care, was cited as a reason for poor care. The Royal Commission restarts December 9 in Canberra when it will look into interfaces between the aged care system and the health care systems. The Royal Commission will return to its focus on funding models in 2020.
In response to the interim report of the Royal Commission into Aged Care, PM Scott Morrisson at the end of November promised to spend another $537m on aged care and that reforms would continue as the Royal Commission proceeded. This initial response targets the desperate need for more home care packages, problems resulting from overuse of chemical restraint and the situation of young people in aged care.
- Most of the funds, $496m, will cover an extra 10,000 home care packages
- $25m goes to decreasing use of chemicals to restrain clients in facilities, and this will be combined with new restrictions and more education for prescribers who will also have to get additional approval for prescribing drugs such as Risperidone for longer than 12 weeks
- $10 million over two years will fund dementia training and support for aged care workers and providers – in a bid to reduce use of chemicals for restraint
- $4.7 million will help meet new targets to accommodate younger people with disabilities in suitable homes instead of residential aged care
If you are interested in Sydney Community Services’ wide range of supports to enable seniors and people with a disability to live independently at home, see https://www.sydneycs.org/services-for-seniors
If you’re interested in a summary or detail of the Royal Commission’s interim report, there are news releases, all three report volumes, and a link for anyone wanting to send a submission, at