Analysing CLA’s impact: Aged Care Quality inquiry No 1

The government released the Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia, House of Representatives Standing Committee on Health, Aged Care and Sport, on 22 October 2018.

Civil Liberties Australia made submission No 40 (out of 106 submissions in total) to this inquiry, which was announced in December 2017 and ran for about eight months. (It turned out that the inquiry was a preamble to a full-blown Royal Commission into Aged Care, announced by the government just as this initial committee inquiry was finalising its report – for RC details, see later).

The committee report says: “Australians are living longer, with estimates that there will be 8.7 million older people living in Australia (22% of the population) by 2056. Nearly 240 000 older Australians received permanent residential care in 2016-2017 and, with Australia’s population ageing, demand for care is growing. Complexity of care is also increasing, with dementia rates expected to increase to around one million by 2056.”

How much impact did Civil Liberties Australia have by making our submission? Members often ask what does CLA achieve? Here’s a rundown of the excerpts from the CLA submission which the committee chose to publish in their report. This is an indication of which of CLA’s comments achieved ‘cut-through’. There are six:

3.76  Civil Liberties Australia stated that staff training around the delivery of medication is ‘sometimes inadequate’, and that ‘the quality of life for some residents would be diminished by medications not being given correctly’. Footnote 97 (page 74)

3.133  Greater protection of staff of aged care facilities was also recommended by Civil Liberties Australia, which stated that staff in these facilities are often vulnerable:

Staff of residential facilities need greater whistle blower protection than do average Australians: they are usually poorly paid, very job dependent, and relatively powerless in society. They fear sacking, which would in practice lead to virtually no chance to get a job in a similar facility. 159 (p86)

3.147  Volunteering Australia recommended that whistle blower provisions be extended to apply to the volunteer workforce in residential aged care. The QACAG called for more protection for residents, relatives and others to raise concerns regarding the quality of care. Civil Liberties Australia suggested an annual, national award for courage be administered for staff who raise issues over quality of care. 176  (p89)

4.14  Civil Liberties Australia stated that a greater focus should be placed on maintaining the rights of older Australians:
Australians don’t lose rights and liberties when they pass an age milestone, say 70 years. If anything, they should gain greater rights, more respect, increased consideration and extra care. That is not how the system works now. 13 (p101)

  1. 72 Civil Liberties Australia set out the challenges faced by family members trying to navigate the aged care system, and the vulnerabilities that exist for those without assistance. Civil Liberties Australia stated that:

… a single person would find it extremely difficult to navigate the system to find a place in residential care. Being alone and in poor health, lacking computer skills and access to transport would be virtually insurmountable obstacles. Financial problems including the sale of a house to fund the accommodation deposit could expose older people to unscrupulous ‘service’ providers. 85 (p114).

5.17  Civil Liberties Australia put forward the view of an older Australian, who called for a change in culture around aged care:

… aged care in Australia is primarily regarded as in need of better management … but not needing an entirely different value given to old age. Nowhere is it seen as a priority to listen to and speak with elderly people themselves, as the main people that Aged Care should be for. 19 (p129).   ENDS EXCERPTS

Civil Liberties Australia hopes our submission to this “preliminary” inquiry, and the committee’s excellent report, has set the scene for the Royal Commission to look closely at:

  • rights and liberties of older Australians, which should not diminish with age;
  • consulting aged people themselves before making decisions about them; and
  • much greater whistle blower protection for staff of aged care facilities.

The committee’s 14 recommendations include one on the rights and liberties of elderly Australians, which was one of the prime concerns in CLA’s submission.

Recommendation 5

2.177   The Committee recommends that the Department of Health ensure consumer information, including the Charter of Rights, for aged care residents and their families is available in a wider range of languages to ensure better access for those from culturally and linguistically diverse backgrounds.

CLA was also pleased with two other recommendations:

Recommendation 7

2.179  The Committee reiterates and supports the recommendation from the Carnell-Paterson Review to move to unannounced audits in residential aged care facilities and that any unannounced visits to residential aged care facilities should not be confined to business hours.

Recommendation 8

3.178  The Committee recommends that the reportable assault ‘resident-on-resident’ exemption, in which assaults committed by a resident with a cognitive impairment are not required to be reported to the Department of Health, be removed.

The committee, however, decided in its reporting to highlight only these recommendations:

  • 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 received evidence which highlighted gaps in the current system for the delivery of care in residential aged care facilities,” the chair, Trent Zimmerman MP, said.

On 16 September 2018 the Australian government announced a Royal Commission into Aged Care Quality and Safety (Royal Commission). The Royal Commission is expected to determine the extent of ‘substandard care’ being provided, and will also consider challenges associated with providing care to people with disabilities living in aged care and older Australians with dementia and complex care needs. In addition, the Royal Commission will consider challenges and opportunities associated with the expected increase in demand for aged care services over the next decade.

If a Civil Liberties Australia member would like to contribute to the CLA submission to the Royal Commission, please email your comment or contribution to: secretary[at]cla.asn.au

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