This week in politics

This week saw the release of the House of Representatives Inquiry Report and Recommendations on the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018.  The recommendations, including that the Bill be passed and the Quality Indicator Program be made compulsory may cause some concern for members. However, the Bill would still need to go to the selection of Bills committee before it can be introduced into the Parliament and Federal Parliament is not sitting till 12 February – and then there are possibly only about four sitting weeks (14 sitting days) before a possible election is called – so this Bill is unlikely to be selected.


12 Dec 2018

 

ACSA has written to the Committee Chair and Deputy Chair outlining our concerns and recommending the Bill be referred to the Royal Commission, so the system can be examined in a genuinely thorough and open manner, including considering all recent inquiries and reports, to eventuate with the design of an aged care system the Australian community wants and needs.
 

ACSA has also pointed out to the Chairs that:

  • ACSA supports sustainable staffing levels and an appropriate skill-mix across the sector to support quality care. We also understand the community’s desire for increased transparency and information when choosing care for themselves and their loved ones.

  • ACSA is very supportive of 24/7 RN cover and adequate staffing where it is needed in those services whose residents require a high level of clinical expertise at all times.  However, there are also factors other than staffing that contribute to quality care including leadership and different models of care, such as the Household Model.[1] 

  • An overseas study, undertaken in 55 nursing homes, has concluded: The general belief is that the number of total staff hours per resident day (HPRD) and the staff mix (% registered nurses/total staff) are associated with quality of care (QoC) in nursing homes. However, findings from studies examining these relationships are inconsistent, Overall, we were unable to demonstrate a relationship between HPRD and QoC. Our findings underscore that focusing on quantity of nursing care might not improve QoC in nursing homes. The quality of the team should be taken into consideration as well.[2]

  • One of the most important indicators of residential aged care is what consumers and their families think of the care they receive. This is evidenced by the recent release of the Consumer Experience Reports undertaken by the independent Australian Aged Care Quality Agency (AACQA). This first report, with interviews undertaken from 1 July 2017 to 30 June 2018, was with a very large independently chosen random sample of 15,000 aged care residents in over 1,100 residential aged care services.

  • Overall, the consumer feedback on the quality of care and services was very positive: About 98% per cent of those interviewed said staff treat them with respect “most of the time/always”; and 98% said they feel safe “most of the time/always”.  While ACSA acknowledges there are unacceptable instances of poor care and neglect – the vast majority of care delivered is of a high quality according to those who receive it.

  • Overall, aged care providers have shown a commitment to delivering high quality services to those they care for - despite a funding mismatch with community expectations, ACFI indexation reductions, and with many aged care facilities making losses.

  • The recent StewartBrown FY2018 Aged Care Sector Report,[3] shows that 45% of residential aged care facilities operated at a loss in FY2018 (34% in FY2017), with that increasing to 63.5% in RRR areas (58% in FY2017).

  • This is reaffirmed by the recent Federal Government Aged Care Financing Authority supplementary report which concludes that providers: operating in RRR areas; providing services to the homeless; and, those with large numbers of low means/concessional residents, are facing particular pressures and that consideration should be given to enhancing the support provided to them.[4]

  • In his recent Workforce Strategy report, Dr John Pollaers said the taskforce acknowledged that: funding (including consumer contributions) does not always meet the full costs of delivering aged-care services.[5]

  • Aged care providers receive about $260 a day[6] to look after a resident compared to the funding of $2,005 a day[7] to care for an acute hospital patient.

  • In relation to the Recommendation that the QI program be made mandatory, many aged care providers already have effective programs in place actively monitoring areas covered in The National Aged Care Quality Indicator Program (QI Program) covering clinical areas such as the management of falls and unplanned weight-loss. A provider is assessed and monitored through the current Aged Care Quality Standards by the AACQA.

  • ACSA is actively working in partnership with Government on how best we can assure the community of appropriate care in Australia’s aged care facilities – the vast majority of which already provide quality care.

  • The industry is now also implementing the new single quality standards commencing 1 July 2019. The sector is also preparing the new Aged Care Quality and Safety Commissioner commencing 1 January 2019.

  • We support the Government’s decision to hold a Royal Commission into aged care and will work co-operatively and transparently to ensure it will ultimately contribute to delivering quality and sustainable aged care into the future, and that we have a system the community wants and how that is then funded.


The Ratio Disclosure Report and Recommendations are here

If you have any government relations questions, do not hesitate contact Heather Witham on: heather.witham@acsa.asn.au

 

[1] Residents live in small households being look after by carers, with clinical staff delivering nursing/medical/allied health care into those small households as required. An example is here: https://uniting.org/services/aged-care/residential-aged-care/household-model

[5] https://agedcare.health.gov.au/aged-care-workforce-taskforce-strategy-report

[6] https://agedcare.health.gov.au/reform/aged-care-financing-authority/2018-acfa-annual-report-on-funding-and-financing-of-the-aged-care-sector

[7] Independent Hospital Pricing Authority, National Hospital Cost Data Collection, Australian Public Hospitals Cost Report 2014-2015 Round 20, www.ihpa.gov.au/publications/national-hospital-cost-data-collection-public-hospitals-cost-report-round-19-financial, p.13