Royal Commission into Aged Care Quality and Safety – Interim Report

Urgent Action

The Report identifies 3 key areas where there is a need for urgent action:

1. To provide more home-care packages to reduce the waiting list for high level care at home;
2. To respond to the significant “over-reliance” on chemical restraints; and
3. To stop the flow of young people with disability going into aged-care homes.

While the 3 recommendations above are prioritised, the Report also identified the following serious problems:

• inadequate prevention and management of wounds;
• poor continence management;
• dreadful food, nutrition and hydration, and insufficient attention to oral health;
• a high incidence of assaults by staff on residents and by residents on other residents and on staff;
• common use of physical restraint on residents, not so much for their safety or wellbeing but to make them easier to manage;
• widespread overprescribing, often without clear consent, of drugs which sedate residents, rendering them drowsy and unresponsive to visiting family and removing their ability to interact with people; and
• patchy and fragmented palliative care for residents who are dying, creating unnecessary distress for both the dying person and their family.

The Report also concludes that the aged care system lacks fundamental transparency.

At the time of writing the Federal Government had committed to responding to the Report next month (in December 2019).

The Report also outlines what the Commission will be looking into in the balance of the hearings.

Future Hearings

Hearings for the remainder of 2019 will focus on:

• provision of aged care in regional areas;
• aged care operations of selected approved providers; and
• access and interface issues between aged care and health services.

Some of the issues to be explored in future hearings in 2020 include:

• the funding of aged care and the impact it has on how care is delivered;
• integration and transition between different parts of the aged care system, including home, residential and respite care;
• governance and accountability in aged care;
• how to identify and encourage innovation and improvement in aged care;
• models for the delivery of aged care;
• system architecture and design to support a good quality of life for people using aged care services; and
• how best to deliver aged care in a sustainable way.

Research

The Commission’s research team is also conducting and commissioning work in the following areas:

• community attitudes to ageing and aged care;
• the quality of life, satisfaction with care and extent of sub-standard care in both home care and residential care;
• understanding the cost of care and how much it costs to deliver an acceptable standard of care;
• the accessibility of aged care services in rural and remote areas;
• the extent of differences in the care experiences of people with low income or wealth;
• understanding the aged care systems in other countries;
• innovative models of care, including internationally;
• financial analysis of the state of the aged care industry and its different segments; and
• modelling the economic and budgetary implications of various scenarios and structural options for aged care.

Piper Alderman will continue to monitor the Aged Care Royal Commission, and its further work.