The Royal Commission in to Aged Care – What’s Coming Next?

Alongside the Health Sector, 2020 has made the most significant impact on the Aged Care Sector across Australia; but it’s not over yet I’m afraid. In fact it’s only just getting started! Last month the Final Hearings (and subsequent Response to Counsel Assisting’s final submissions) came to a close for the Royal Commission in to Aged Care.

It was during the final hearing that Counsel Assisting reminded the Commissioners (the Honourable Tony Pagone QC and Ms Lynelle Briggs AO) that at the very first hearing in early 2019, the late Commissioner Tracey stated “The Royal Commission is a once in a lifetime opportunity to come together as a nation to consider how we can create a better system of care for elderly Australians that better aligns with the expectations of the Australian people”.

The purpose of the Royal Commission in to Aged Care (the RC) has been to confront a system that whilst for the most part tries the best it can with what little it has; however it’s still not good enough when vulnerable older Australian’s health, wellbeing and in some cases lives are in our hands. This falls upon the shoulders of the Australian Government but also Aged Care Providers equally.

Since commencing in January 2019, the RC has received 10,144 submissions and 6,729 telephone calls to the information line, conducted 25 hearings and workshops, 12 Community Forums, 2 Community Meetings, and visited 29 service providers.

Over this time a substantial amount of information has been shared highlighting the sector wide failings of a system that is long overdue for a shake-up.
Some of the RC’s initial recommendations involved requesting immediate Government action to:

1. Provide more Home Care Packages to reduce the waiting lists for high level care;
2. Address the over-reliance on chemical restraints predominantly in residential care; and
3. Stop ANY person aged under 65 with disability from entering or remaining in aged care facilities.

While these 3 initial recommendations aren’t necessarily ‘quick wins’ for the RC (given there is still so much to work through), the Government did commence putting in place measures to work through the release of additional Home Care Package funding (albeit for lower level places not the high-level as recommended).

The Government also created a package of initiatives to help reduce the use of physical and chemical restrain in aged care homes. This will be supported by further updates to legislation and the development of educational messaging for pharmacists, nurses and personal care workers, approved providers of residential aged care services and families and decision makers.

Lastly the Government strengthened the Younger People in Residential Aged Care (YPIRAC) targets and ensure the 2020-2025 strategies would prioritise:

• Preventing younger people from entering residential aged care;
• Supporting younger people to leave residential aged care; and
• Supporting younger people while they are in residential aged care.

With the final report from the RC set to be released in February of next year (2021), it is clear this only just skims the surface of what needs to happen next.

In the October 2020 Final Hearing, Senior Counsel Assisting Peter Gray QC and Peter Rozen QC, presented submissions on behalf of the Counsel Assisting team over two days. They submitted 124 recommendations for consideration that focussed on the apparent poor care, lack of staff and support and how difficult it can be for older Australian’s to speak up/complain.

Given so many of our countries aged consumers currently accessing or needing care are considered part of the ‘silent generation‘, Commissioner Briggs and the late Commission Tracey made a point of reassuring the Australian public that they would “drive [their] policy agenda beyond change at the margin to transformative change, given the degree of substandard care that was apparent to [them]”.

As a result, the 124 recommendations tackle (to name a few):

• A whole new Aged Care Act by 2023
• The development of an Australian Aged Care Commission, Aged Care Advisory Council, Australian Aged Care Pricing Authority and hiring of an Inspector-General of Aged Care
• Improved public awareness of aged care
• Urgent review of the Aged Care Quality Standards
• Increase in Award wages, the development of a national personal care worker registration schedule (like the NDIS) and mandatory minimum qualification for personal care workers
• Improved complaints management processes and many more.

Greater weight is also to be attached to the consumer experience, something providers have struggled with for many years. While Consumer Directed Care is not a new concept for any provider, the recent findings from the National Ageing Research Institute (NARI) show that the majority of residential and home care consumers feel their needs are “mostly” not met and levels of satisfaction are low as a result. This is something that ALL providers need to start thinking about NOW including the investment they need to make back in engagement and collaboration with consumers. For those larger providers with thousands of consumers receiving support Australia wide – this is likely a message for you!

Lastly, the RC hasn’t forgotten about those new organisations wishing to jump through the hoops to become a new approved provider. You get a special mention too. One of the final recommendations is to create new approval requirements for all aged care providers, meaning the process is likely to become even harder than it already is – and rightfully so.

With consumers so vulnerable and silent in nature they can’t afford for anyone to get this wrong, especially the Commission making the decision.