The aged care industry is facing wide-spread reform, with most facets under scrutiny following the release of the Aged Care Royal Commission report on 26 February 2021. It is clear there is a pressing need for skilled and experienced leaders to implement change across the board. Lack of funding and a widespread shortage of qualified case workers and carers has seen the industry – and the quality of care provided to our aging population – suffer. As such, major challenges facing leaders in this field will be pushing for systemic change and funding as well as sourcing, training and retaining skilled in-home carers to drive dramatic improvements in care.
The Aged Care Royal Commission final report confirmed the aged care system is in genuine crisis and detailed shocking statistics on how people are treated in aged care. One of the sad statistics revealed is that 2/3 of people in residential care are malnourished or at risk of being malnourished.
The revelation of the challenges and failings are mainly around the lack of funding and staffing and the sector not keeping pace with the needs of older Australians or expectations of the wider community. For the recommended overhaul of the system to work, the sector needs to have a high-performing and sustainable aged care system that meets the needs of older Australians today and in the future. This includes having the right people at senior levels driving change and building highly skilled and capable teams around them.
Over the years the approach has been ambivalent and successive Governments who are responsible for the aged care system have not taken the needs of older Australians into account. It would appear Government who set the rules and regulations and administer the system have put the fiscal needs of the budget ahead of the individual’s needs. The Royal Commission has called this out, providing a once in a generation opportunity to put older Australians first.
There needs to be a commitment from both the Government and aged care sector to deliver a needs-based system. Unfortunately, there was a split between commissioners, and they have reached different views in certain areas on how to tackle the problem. However, they don’t fundamentally disagree on what the vision for a new system should be and hopefully these variations can be managed.
One area that is broken is home care and there are simply not enough places and packages on offer, as well as not offering the right sort of packages. There are almost 100,000 elderly people on waiting lists and according to the Productivity Commission there is a 28-month wait time for people requiring the highest level of care.
Dr Stephen Duckett is the author of a recent Grattan Institute report that proposes a rights-based system that guarantees universal access to care and support for all who need it. Spending an extra $7 billion a year could provide all older Australians with the care and support they need, according to this report.
It really goes to the basics that older people have rights and should be able to receive good care, just as every Australian has the right to medical care and there is no cap on how often we visit a doctor or medical specialist.
In this ABC News article, Dr Duckett, states aged care recipients should not only have access to the care, but should also have a broker to help manage that available care to avoid providers exploiting the system and charging too much. He said the current approach which allows providers to charge excessive administration and management fees must change.
“The providers will say, we’re going to charge 30 per cent to manage your package, and that’s a common fee, and so even if you don’t use all of your package, you have to pay this standard amount,” Mr Duckett said.
“The second thing is sometimes the fee per hour is very, very, very high, and so people can be exploited by ruthless providers and not have the care that they need, and they’re paying way too much because there’s no-one to help them in negotiating all of this.”
System settings, policy regulations and resourcing must be overhauled to enable aged care providers to employ more staff, who are qualified, better skilled and appropriately remunerated.
Equally important is that a redesigned system will enable clear measurement of data and ensure quality of life outcomes for every individual are clearly measured. This will also enable comparison across services and services providers, as well as benchmark for continuous improvement.
There are 148 recommendations in the report. A main priority must be the reduction of the home care wait list and secondly giving better support and training to aged care workers who work under very challenging circumstances with limited resources.
As well as legislative, regulatory and structural change, operational matters have to be tackled on how to attract, retain and develop a workforce and how to put measures in place to ensure alignment with quality standards.
All this needs to be focused on the needs of older people and how to tailor services that are delivered to them when and where they need them.
Leaders in this field certainly have challenges ahead of them. However, there is also a huge opportunity to design a fair and effective aged care system, creating a legacy for future generations and providing the level of care and dignity all people really deserve.
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Sybille Goss
Photo by Micheile Henderson on Unsplash