Aged care royal commission: Home care should be prioritised over residential aged care

Focus on home care would give older Australians what they want and benefit the budget bottom line, the aged care inquiry hears.

Home care should be urgently prioritised over residential aged care to give older Australians what they want and help the budget bottom line, the Aged Care Royal Commission has heard.

And COVID-19 is likely to discourage people even more from wanting to end up in a nursing home, senior counsel assisting the commission Peter Gray said.

In his opening address to the commission as it examines the home care system, Mr Gray also criticised the aged care regulator for its recent lack of oversight of home care providers.

“There should be a far more urgent effort to prioritise home care over residential care,” Mr Gray said.

“This is not to disparage residential care. There will always be a place for high quality residential care. But, as the research indicates, it is not generally the setting a person would choose.”

“The current COVID-19 pandemic is likely to reinforce people’s general preference to age in place at home and do all they can to avoid admission to residential aged care,” he said.

Australia has the highest proportion (19 per cent) of people aged 80 or over in residential aged care in the developed world, the commission heard, despite numerous surveys saying people want to stay living in their own homes to maintain their independence.

Helping people stay in their home makes more economic sense, Mr Gray said, costing the Commonwealth $71 per day per person with a home care package compared to $191 a day in residential care.

Yet more than 100,000 people have been assessed for home care packages that have yet to be provided, he said.

“If people don’t get the home care they need, they deteriorate, their quality of life is diminished, they will be more likely to have to go hospital, and they are more likely to lose their capacity for independent living and enter residential care,” Mr Gray said.

“Thus the current delays and failures to provide assessed care are not only inhumane, but have obvious and serious systemic consequences that are damaging to the aged care system, the healthcare system and the government’s Budget.”

Mr Gray levelled criticism at the Aged Care Quality and Safety Commission, the sector regulator, for not providing sufficient oversight of those who are providing home care services.

“There appears to have been a steep fall in regulatory activity by the regulator since July 2019.

“Since July 2019 there has been a dramatic decrease in the number of quality reviews, audits and assessment contacts conducted by the ACQSC assessors,” he said

Mr Gray said the aged care quality and safety commission cited a high level of staff turnover and having to deal with large numbers of residential care issues as reasons for fewer reviews in home care.