Our world has changed

OUR WORLD HAS CHANGED COVID-19 AND THE AGED CARE ROYAL COMMISSION

The world into which the Royal Commission has been inquiring has changed considerably and with it the Royal Commission activities. At the end of January 2020, the focus was on the submissions into the Future of the Aged Care Workforce and the proposed findings presented to the Commissioners at the hearing on 21 February.

These findings focused on 11 recommendations from Counsel, including:

An appr oved provider of residential aged care services should have to meet mandatory minimum staffing requirements. Register ed Nurses (including nurse practitioners) should make up a greater proportion of the care workforce than is presently the case. All aged car e workers should receive better training. Unr egulated care workers should be subject to a registration process with a minimum mandatory qualification as an entry requirement. The care workforce should be better remunerated and should work in safe workplaces. The or ganisations for which they work should be better managed and governed. The Australian Government should provide practical leadership.

Alongside this process, the Royal Commission sought submissions on the future design of the aged care program which culminated in the first of the new style workshops on 10-11 February in Adelaide.

New style panels of experts and sector representatives, including LASA CEO Sean Rooney, commented on a variety of topics in a question and answer type approach led by Counsel.

Following this, a suite of suggestions on program redesign were put by Counsel to the Commissioners at their hearing on 4 March. These broadly aligned with LASA’s proposal on system architecture and included:

Needs-based entitlements to aged car e. Linking funding levels to actual costs. Uncapping supply of funding packages and places. Reorientation toward wellbeing and independence. Easier access, car e finding and case management support. Innovative accommodation options driven by choice. Improved data collection and analytics.

The next workshop on Research, Innovation and Technology was held in Adelaide on 16-17 March, but the format already presented the changing response to a COVID-19 reality, with a number of experts presenting remotely.

Consultation activities continued and LASA was involved in an early discussion with the Royal Commission’s Policy and Legal teams as part of their preparatory work on Funding and Finance, however we negotiated an extension on our submission to allow us to focus on our COVID-19 support to Members and the wider industry.

The Royal Commission also wound down, postponing the next announced hearing on Mental Health, Oral Health and Allied Health until July following the announcement that all public consultation activities will be paused. The deadline for receipt of public submissions was extended to the end of June 2020, a deadline that is subject to continual review.

The Royal Commission has weighed into the COVID-19 debate, particularly in light of heightened media and political interest around its impact on older Australians receiving care. In response to the announcement of restricted visiting regimes to residential aged care, Commissioner Pagone issued a statement urging the need for compassion.

The Royal Commission also extended its inquiry remit, in order to review the industry’s response to COVID-19.

The Commissioners will inquire into the management of outbreaks at three facilities (Dorothy Henderson Lodge, Newmarch House and Opal Bankstown) but will also investigate how most home care and other providers avoided outbreaks of disease. They hope to understand the impact of the pandemic upon older Australians, their families and carers, in aged care facilities and receiving home care, the measures put in place to protect them, and consider how best to react to such events in the future while balancing the need for safety and wellbeing for all.

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Our LASA team will prepare our own Royal Commission submission into COVID-19 based on the experiences of our Members and our engagement on your behalf through this emergency, noting our key observations:

Overall aged care has been effective at protecting older Australians, particularly when compared with international experiences. The restriction to visitors has been well supported by residents and the community. The lack of consultation with industry on major decisions and often a lack of timely information about implementation has left some questions unanswered. The lack of national consistency due to the federated nature of emergency response has had a significant impact on practical implementation and a tension which providers experienced because of the number of agencies with oversight. The planning response to procurement and competitive neutrality has meant providers found themselves expected to have sufficient PPE but faced supply chain and price gouging and a disappointed expectation of support from the national stockpile. While funding announcements have been appreciated they are insufficient and poorly targeted. Home care has largely been overlooked in the government response with far lower attention or resources despite the fact that the larger proportion of older Australians are cared for in the community.

As the community at large moves to a post-COVID approach to activities, the Royal Commission is making sure the sector’s response to the pandemic gets its full attention, and adds to the most comprehensive review into our industry to date. ■ Jane Bacot-Kilpatrick is COVID-19/Aged Care Royal Commission Project Coordinator, Leading Age Services Australia.

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