The Aged Care Royal Commission has been in and out of the news over the last two years and the final report was made public on Monday 1 March, 2021. There’s been so much written and discussed about it from lots of different perspectives. So much in fact, it can be overwhelming, confusing and frightening.
Here we try and explain some of the key points that might be important to the children of ageing parents. There’s so much to go through (we still haven’t finished reading the report), but it will give you a good high-level overview of what’s going on.
Please note when we talk about aged care in this article, we’re not only talking about residential aged care (nursing homes), we’re talking about aged care services that cover both in-home care and residential. With more people wanting to stay in their homes for as long as possible, this area of aged care will continue to grow.
Please also note that some of the witness statements, submissions and findings of the Aged Care Royal Commission contained stories of abuse and neglect and may trigger people who have had or know of similar experiences. If reading any of this or the reports upsets you or the people around you, please take care of yourself. Practice self-care and seek help if necessary. We have included some resources at the end of the article so scroll to the end if needed.
Lastly we know that there’s a lot of bad stuff going on in the world and the last thing you want to think about is bad stuff happening to your parents when receiving aged care services. Despite this damning report, there are good service providers out there. Our aim is to arm you with knowledge, so you know how to find them. And hopefully if the recommendations of the Aged Care Royal Commission are followed, the system will improve so this level of abuse doesn’t happen again – fingers crossed!
What is the Aged Care Royal Commission?
Officially it’s known as the Royal Commission into Aged Care Quality and Safety. It was established on 8 October 2018 to investigate the quality and safety issues in the sector and provide recommendations to the Federal Government for improvement. The terms of reference outline the specific areas the Royal Commission had the authority to investigate.
What did the Aged Care Royal Commission do?
The Aged Care Royal Commission was a public inquiry so it sourced information from the general public and experts. Thousands of people shared their experiences of the aged care system – both residential and home care. The Aged Care Royal Commission received more than 10,000 submissions, held workshops, community forums and public hearings which heard from more than 600 witnesses.
Over two years, the Royal Commission team made of up Royal Commissioners and lawyers known as Counsel Assisting the Royal Commission, gathered the evidence, wrote reports and made 148 recommendations in the final report (on top of the recommendations made in the interim report and a special report on COVID-19 and Aged Care).
What did the Commissioners say?
There’s a lot the Commissioners had to say – the final report covers five volumes! Overall, the Commissioners called for fundamental and systemic reform of the aged care sector. This means the whole system needs an overhaul as it’s no longer meeting the needs of older people. In fact, a lot of what they uncovered included stories of neglect and abuse.
“The extent of substandard care in Australia’s aged care system reflects both poor quality on the part of some aged care providers and fundamental systemic flaws with the way the Australian aged care system is designed and governed. People receiving aged care deserve better. The Australian community is entitled to expect better.”
Royal Commissioners Tony Pagone QC and Lynelle Briggs AO in the final report.
The Commissioners found that the system was too much in favour of the providers, rather than older people and their families. Their recommendations look to fix this.
The press release announcing the final report is available here: https://agedcare.royalcommission.gov.au/news-and-media/final-report-calls-fundamental-and-systemic-aged-care-reform
What did the final report recommend?
There are 148 recommendations presented in the final report that cover a wide range of issues older people in Australia face when it comes to aged care. We’ve summarised just a few of them here:
- A new Aged Care Act that really puts older people first (currently it’s written from a provider point of view, not a recipient point of view and limits the protections of older people). This is the law that governs what happens in the aged care sector.
- Better reporting and regulation with the establishment of a new regulator which makes findings public (currently public access to information is limited). There is also a recommendation for a star rating (like hotels etc).
- Better access and more timely information. They are also suggesting care finders to help people navigate the system. In our view, if the system wasn’t so complicated, you wouldn’t need a care navigator, but it’s a step in the right direction. We’ll continue to try and make it easier for you to access information through our site.
- A focus on restorative and preventative care with increased access to allied health care professionals such as physios, mental health services etc. This is different to the current focus which appears to be more about minimal levels of service to keep people alive. The current system doesn’t seem to be about maintaining and improving quality of life. Hopefully this will change with a new system.
- An improved aged care workforce with a greater number of higher trained staff, better labour conditions, registration of personal care workers and a minimum quality and safety standard for staff in residential aged care. This means having at least one registered nurse on site at all times and a better mix of trained nurses and personal care workers. Currently the majority of workers in aged care facilities are care workers who don’t have the same training and experience as nurses. There’s also sadly not enough staff on duty which really impacts the standard of care. In home care, there’s also not enough trained staff, especially in regional and rural areas.
- Changed financing arrangements so that people don’t necessarily have to sell their family home to enter aged care which might include an aged care levy for taxpayers that can afford it, similar to the Medicare levy (this has been ruled out by the Government at time of writing, but could still be on the cards as the Labour Party is looking at having it as part of its election issues platform).
Will all the recommendations be adopted?
No. Within the recommendations the Royal Commissioners have offered different options on how to achieve change so the Government will pick and choose which recommendations it will adopt and those it will ignore.
Sadly, the federal governments over the last 20 years have talked the talk on reform, but have done little to overhaul the system to benefit older people. Since then, there have been around 20 inquiries into aged care. Hopefully this time is different.
When can we expect to see any change?
This depends on how the Government responds to the recommendations. Within the final recommendations, there are some dates set as early as 15 July 2021 to address some issues (this one is about urgently addressing some of the quality standards – Recommendation 19). However, the Government has already said it will take up to five years to make some of these changes. Frankly, it’s not good enough and there will be intense pressure to have some of the recommendations addressed sooner rather than later.
How does it impact me and my ageing parents?
In the short term there is no real impact on you and your parents as there has been no action taken on the recommendations. However, the positive news is that there is hope that in the medium to long term, the system will be reformed to give your parents the services they need to live a great life. This is also setting the system to be better when our time will inevitably come.
What if I’m having issues with my parents’ service provider now? How do I make a complaint?
If you’re having problems with your provider, remember the issue of aged care rights is now in the spotlight. This should hopefully mean that providers are more receptive to resolving issues.
Contacting the provider
If you feel comfortable, often the best way is to raise the issue first directly with your service provider. You could discuss the issue with them and then follow up with an email (it’s always a good idea to have it writing, so an email is a good way of having a record of the complaint, what was said, who it went to and when). Each provider has their own complaints handling process.
Going to the Government regulator -the Aged Care Quality and Safety Commission
If you’re not satisfied with the outcome, or you don’t feel comfortable in going to the provider directly, you can make a complaint to the Aged Care Quality and Safety Commission online or by calling 1800 951 822.
Identifying systemic issues with issue.watch
Sometimes we can made to feel like our issue is an isolated incident, when in fact it could be a common problem with that provider. In tandem with your other complaints processes, you can also lodge your complaint with issue.watch. Issue.watch is an independent complaints tracker that aggregates complaints. If it identifies systemic issues, it can call on that organisation to help make changes.
What happens now?
While the Government decides what it wants to do, there will be an intense lobbying effort from all sorts of interest groups involved in the aged care sector. With this year likely to be an election year, many are hoping that aged care can be an election issue.
The Government has said it will provide its response as part of the May Federal Budget. This gives you a clue that a lot of it is going to be about funding.
What groups are lobbying and why?
A “people-powered” movement, Aged Care Reform Now* has been launched to represent the interests of older people and their families. The group is advocating for:
- A new Aged Care Act that focuses on the human rights of older people
- Effective regulation
- Financial transparency
- Increased staffing levels and skill mix
- Disclosure of performance indicators
- Public access of regulator’s spot-check reports
- Public reporting of complaints including how they were managed and resolved
- Mandatory reporting of elder abuse
- Home care that prioritises each individual’s need for support
- Working with older people and families when designing aged care services
The group’s website outlines what it’s all about and how you can get involved. There is also an Aged Care Reform Now Facebook Group which is very lively and full of passionate people.
On the other side of the fence, aged care service providers have united under the Aged Care Collaboration banner to also lobby for change. The group has a website – careaboutagedcare.com.au which includes a petition calling for people to encourage their member of Parliament to reform the aged care sector and support the rights of older Australians, which on first glance is a positive thing. HOWEVER, what isn’t very obvious from the website is that it’s the providers who are behind this petition.
There is a report listing all the problems with the sector which is helpful, but they do not claim responsibility for their role in the failings which is disappointing. The main point of their lobbying efforts is to have more government funding of the sector. While the sector does need more money, it should come with strings attached – with strict accountability and transparency about where the funds go. As taxpayers and “aged care consumers” we should know that funds are directed to better quality care of older Australians, not necessarily the profits of providers.
How can I learn more about this?
Read, watch, listen.
There’s deservedly been some media attention on aged care issues with some great journalists covering the space. I’ve included a few initial articles here, and you can continue to follow the journalists and commentators in this space to learn more.
- Anne Connolly, ABC – https://www.abc.net.au/news/anne-connolly/10254422
Anne’s article “I’ve got four reasons to be positive about the aged care royal commission” is a great snapshot. https://www.abc.net.au/news/2021-03-03/reasons-to-be-positive-about-australian-aged-care/13209060
- Jewel Topsfield, The Age/ Sydney Morning Herald – https://www.theage.com.au/by/jewel-topsfield-hve7k
This explainer from Jewel “24 years, 18 inquiries: can we face the truth of aged care?” is great background for anyone that wants to understand our current aged care system and what change is needed. https://www.theage.com.au/politics/federal/24-years-18-inquiries-can-we-face-the-truth-of-aged-care-20210225-p575qs.html
- Rick Morton, The Saturday Paper – https://www.thesaturdaypaper.com.au/node/8580
This article from Rick covers the issues in the sector (note you need to be a subscriber to read the full article). https://www.thesaturdaypaper.com.au/2021/03/01/aged-care-royal-commission-report-lashes-failing-sector/161458200011192#hrd
This is all a bit traumatising. What can I do to protect myself?
It’s easy to get bogged down by all the negative news out there. Sometimes you just need a break, need to practice self-care or speak to a professional if it has triggered something
Take a break
This is a great summary of why the news can make you stressed and what you can do about it. https://www.calmmoment.com/wellbeing/how-to-cope-when-the-news-makes-you-feel-stressed-and-depressed/
This article from the ABC provides some great tips on self-care. https://www.abc.net.au/everyday/an-illustrated-guide-to-bace-self-care/12136186?fbclid=IwAR3CQs-Ft5XScpGUD-OlQI9D1YEqA1-OP8sRgrCjzDWKJwukQOOwLvl3CvQ
Seeking professional help
There are several organisations that can help either over the phone, via text message or email. Check out the following websites for more details.
- Beyond Blue – Anxiety, depression and suicide prevention support – Beyond Blue
Phone: 1300 22 4636
- Lifeline – https://www.lifeline.org.au/
Phone: 13 11 14
Resources for self-care
This article provides ideas on how to keep physically and mentally well by dividing daily activities into four categories: Body care, Achievement, Connecting with others, and Enjoyment. – https://www.abc.net.au/everyday/an-illustrated-guide-to-bace-self-care/12136186?fbclid=IwAR3CQs-Ft5XScpGUD-OlQI9D1YEqA1-OP8sRgrCjzDWKJwukQOOwLvl3CvQ
You could take a 14-day self-care challenge, or simply read this article with some great tips on how self-care is really health care. We really loved point 11, Meet your ‘inner elder’ – https://www.calmmoment.com/wellbeing/take-part-in-our-14-day-self-care-challenge-with-suzy-reading/
Some more useful links
Aged Care Royal Commission specific information
- The Aged Care Royal Commission website has a frequently asked questions page – https://agedcare.royalcommission.gov.au/about/frequently-asked-questions
- The Aged Care Royal Commission hearings are available to watch or listen to on YouTube – Hearings YouTube channel While Transcripts of hearings are also available on the Aged Care Royal Commission website – Public hearings document library | Royal Commission into Aged Care Quality and Safety
- The announcement from the Commissioners about the release of the final report – https://agedcare.royalcommission.gov.au/news-and-media/final-report-calls-fundamental-and-systemic-aged-care-reform
- The final recommendations of the Aged Care Royal Commission – https://agedcare.royalcommission.gov.au/publications/final-report-list-recommendations
- A great article https://www.abc.net.au/news/2021-03-02/aged-care-royal-commission-final-report-key-takeaways/13203508
- The Older Persons Advocacy Network, OPAN – https://opan.org.au/
- Issue watch website to lodge a complaint – https://issue.watch/directory/aged-care/
- The My Aged Care website information on complaints – https://www.myagedcare.gov.au/contact-us/complaints
*As we believe in full disclosure and transparency, we wanted to let you know that the author is part of the launch team of Aged Care Reform Now and Carers’ Circle is a supporting partner organisation.
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