Providing high quality residential care to older Australians is an obligation we have as a society and a parliament. It is both a debt we must pay to those generations who have done so much to build our prosperous nation and also a fundamental human right.
Australia’s residential aged care facilities provide care to nearly 240 000 Australians. Many are providing aged care which is delivered to a high standard, and provides older Australians with a safe environment to age with dignity and care.
Yet there are also many who have not had a positive experience of their care – in the worst cases care has involved elder abuse or mistreatment. The Aged Care Complaints Commissioner received around 3600 complaints about residential aged care in 2016-2017, and three per cent of these complaints fell under the definition of abuse.
Recently, Australia’s residential aged care facilities have come under increased scrutiny, as high profile reports of mistreatment have come to light and have been investigated. Failures in the provision of care at facilities such as the Oakden Older Persons Mental Health Service have led to major reforms to the delivery and regulation of residential aged care services, and a number of inquiries and reports into how such a failure could occur.
While perhaps the worst example, Oakden cannot be seen as an isolated event. Investigative reporting has highlighted other serious examples of mistreatment and this inquiry has received submissions from residents and family members often outlining what can only be described as harrowing experiences.
This is simply not acceptable in a nation like Australia.
The Committee received evidence which highlighted gaps in the current system for the delivery of care in residential aged care facilities. These included the complexity of the current system, a reluctance or inability to raise concerns or make complaints regarding the quality of care, and an overall lack of consumer focus. The Committee thanks all those who shared their stories and experiences, and understands that the residents, family members and carers who participated in the inquiry did so under difficult circumstances. These experiences helped the Committee understand the challenges of navigating the current system, and the emotional and physical toll of mistreatment.
This parliamentary inquiry has followed a number of government-initiated reviews all of which have made important contributions. More recently, the seriousness of concern about mistreatment in the aged care sector has led the Australian government to establish a Royal Commission.
The Committee has welcomed this announcement and the continued focus on quality and safety in aged care.
At the same time the Australian government has been implementing a number of major reforms flowing from the work of earlier inquiries. This has made the work of this Committee more challenging in what has been a changing regulatory environment. However, in the main the Committee has supported the thrust of those reforms as important positive steps to improving the aged care sector.
For example, from 2019, the regulation of Australian Government-funded aged care will be streamlined, with the formation of the Aged Care Quality and Safety Commission. This will bring together the Australian Aged Care Quality Agency and Aged Care Complaints Commissioner, along with the aged care functions of the Department of Health.
Additionally, a Single Aged Care Quality Framework will replace four separate Accreditation Standards with one, which has a stronger focus on individuals, and the Australian Aged Care Quality Agency has already begun moving to unannounced re-accreditation audits from announced visits.
While it is too early to examine whether these sectoral reforms will be effective, the Committee considers that they are a positive change and will lead to a stronger and more responsive residential aged care sector.
As Australia’s population lives longer, demand for aged care services will inevitably grow. By 2056, it is estimated that 22 per cent of the population will be made up of older Australians. At the same time, nationally, rates of dementia are expected to increase to around one million.
The need for a streamlined, responsive residential aged care system is clear, and recent and upcoming reforms will help the evolving aged care system in Australia.
The Committee has considered these reforms but believes there is more that can be done to improve our aged care system. Our 14 recommendations include:
Improving the Community Visitors Program to ensure volunteers visiting aged care facilities are better able to respond to suspected abuse;
Reviewing the Aged Care Funding Instrument to ensure it is providing both adequate levels of funding and care for aged care facilities;
Ensuring that all aged care facilities are required to have at least one registered nurse on site 24 hours a day and that more work be done to monitor staffing mixes and their impacts on reducing complaints and abuse;
Improving consumer information provided to aged care residents;
Developing mandatory and more effective quality indicators;
Cracking down on the use of restrictive practices;
Developing a consumer rating system for aged care facilities; and
Providing consumers with greater transparency about complaints lodged against individual aged care centres.
The Committee strongly believes that the efficacy of the existing reforms must be reviewed once they are operational, including by this parliamentary committee.
I want to thank the many organisations and individuals who made submissions to this inquiry. I also thank my fellow committee members who have worked together to deliver a bipartisan report. The Committee is also indebted to the work of the Committee staff who have provided such professional support to our deliberations.
Ensuring Australians are provided with residential aged care they can trust must be a priority for the Australian government and parliament. Our hope is this report will provide additional impetus to reform.
Mr Trent Zimmerman MP
Chair