Government reforms to the aged care system: Will they be enough?

Amanda Lyons

19/04/2018 2:34:45 PM

The Federal Government seeks to restore trust in Australia’s aged care system with a suite of reforms to the sector.

The Federal Government’s reform of Australia’s aged care system was prompted by revelations of abuse, neglect and mistreatment at SA’s Oakden aged mental health care facility.
The Federal Government’s reform of Australia’s aged care system was prompted by revelations of abuse, neglect and mistreatment at SA’s Oakden aged mental health care facility.

The decision to place an aged relative into a residential care facility can be a difficult and emotional one, and it is important that people can place their trust in the aged care system.
But last year’s revelations of abuse, neglect and mistreatment at a mental health care service for older patients in Oakden, South Australia, sent shockwaves that served to greatly undermine that trust.
‘It's completely disgusting. No one should have to be treated like that in Australia, in South Australia,’ Clive Spriggs, whose father was a resident at the Oakden facility, told the ABC.
‘Our health services shouldn't be running like that and it shouldn't have gone on for as long as it has.’
The Federal Government this week announced significant reforms to the aged care system in response to a report it commissioned in the wake of the Oakden scandal. According to Federal Minister for Aged Care Ken Wyatt, the reforms aim to boost transparency within the aged care sector, provide greater protection for patients in residential care facilities, and restore confidence in the aged care system.
‘We recognise that the vast majority of providers give consistent, quality care to their residents. But, as we have seen, there can be failures. We must ensure that disasters like Oakden are never repeated,’ Minister Wyatt said.
The centerpiece of the reforms is the establishment of a new national independent Aged Care Quality and Safety Commission. Scheduled to start on 1 January 2019, the Commission will combine the functions of the Australian Aged Care Quality Agency, the Aged Care Complaints Commissioner and the aged care regulatory functions of the Department of Health.

Indigenous-Smoking-(AAP,-Mick-Tsikas)-Hero.jpgFederal Minister for Aged Care Ken Wyatt believes the reforms will provide greater protection for patients in residential care facilities, and restore confidence in the aged care system. (Image: Mick Tsikas/AAP) 
‘The new Commission will give senior Australians and their loved ones a single point of contact when they need help in dealing with claims of sub-standard care,’ Minister Wyatt said.

‘Risks to senior Australians will be investigated promptly and care failures identified faster.’
In addition to establishing the new Commission, further federal reforms will include:

  • developing options for the implementation of a Serious Incident Response Scheme
  • providing a performance rating for aged care facilities against quality standards
  • offering a provider comparison tool on the My Aged Care website.
There has been broad support for the establishment of an independent Aged Care Quality and Safety Commission, but also some criticism of other aspects of the proposed reforms and the Federal Government’s handling of aged care services.
Shadow Minister for Ageing and Mental Health Julie Collins believes the reforms have taken too long and do not go far enough. She also calls for the restoration of lost funding to the sector.
‘[The Federal Government] must use the upcoming budget to deliver genuine new investment in aged care to ensure older Australians are receiving high quality care,’ Shadow Minister Collins said.
Australian Greens Senator Rachel Siewert believes the reforms signal ‘a step in the right direction’, particularly the establishment of the commission. However, she is concerned that the Federal Government has not consulted all of the available research, and questions whether the current standards for aged care provision are strong enough.
‘The Government has not responded to all the recommendations in the various recent reviews,’ she said. ‘It must commit to further reform so that aged care facilities are as safe as can be for older Australians.
‘I welcome a public rating against quality standards, which will increase transparency, but more work needs to be done to ensure that the standards meet community expectations of the best possible care.’
RACGP President Dr Bastian Seidel wants to ensure patient safety and quality of care is the first priority of any reforms.
‘Any new organisation should be able to advise and take action,’ he told newsGP. ‘The goal is to keep people in aged care facilities safe and provide them with the best care available.’
The Combined Pensioners and Superannuants Association (CPSA), however, is unequivocal in its criticism, deeming the reforms ‘cosmetic’ until quality care standards for aged care are also reformed.
‘The new Aged Care Quality and Safety Commission will not change anything until objectively measurable aged care quality standards are introduced and nursing homes are compelled to hire sufficient and adequately qualified staff to meet those standards,’ Paul Versteege, CPSA Policy Coordinator, said. 
‘To treat the Oakden scandal as an aberration and the introduction of a new Aged Care Quality and Safety Commission as the thing that will prevent further scandal is nonsense.’

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Dr Irene Rosul   20/04/2018 8:32:35 AM

I believe the staffs are involved in the nursing home care should be monitor closely and the governing body should organise annonymus monitoring system of the each and every staffs behaviour and their care towards the nursing home residents--so that highly complaint staff should be investigated and removed, if people are not passionate about their care they should do something else---I would suggest it strongly.

Anonymous   20/04/2018 9:51:56 AM

The changes will do nothing. There should be unannounced inspections, relatives should be involved in quality audits and there should be anonymous 360 degree performance reviews of management. There should medium to high home care packages to prevent people from having to go into "care" in the first place. There should be mandatory hearing and vision assessments after all residents entering facilities (not before, otherwise the institutions will find a way to reject the application if a problem is found). There needs to be increased training of GPs to identify mild to moderate cognitive impairment There should be a Montesorri approach to activities and greater use of environmental modification and cues, including the use of colour coding at facilities, rather than the current approach of bingo nights and white / beige decor.

Anonymous   22/04/2018 7:58:25 AM

The main issue in the poor state of our care for the aged is staff/ client ratios. In my 35 years of experience I rarely entered a facility where I could find a nurse with any ease, leaving me to roam empty corridors on the lookout for a staff member . The most caring , most professional, most experienced nurse or PCa cannot do this job properly with the current ratios. Fewer fancy reception areas and more staff please!

Dr A. Sam   3/05/2018 11:27:16 AM

'Anonymous' on 22/4/2018 has identified THE key factor-the poor staff/RN to client ratio in the Australian aged care sector. This excess workload is unfair on staff and clients. It is only good for the nursing home owners' profits. A distance relative in a US aged care facility had one nurse for 2 residents during the dementia phase.