Aged care ‘must get its house in order’

Nursing homes will have to address their culture and leadership before the ailing sector can improve, the Health Department says.

Nursing homes will have to address their culture and leadership before the ailing sector can improve, the Health Department says, warning the aged care royal commission’s lawyers had ignored the issue altogether.

In a newly released submission to the commission, the department and the Aged Care Quality and Safety Commission conceded significant improvements to aged-care compliance and governance were needed, but said quality of care ultimately ­depended on the values and leadership of providers.

“It is accepted by the commonwealth that major reforms are ­required in aged-care financing, provider governance, and quality and safety regulation,” the submission, which responded to the commission’s lawyers’ own damning final submission to the ­inquiry last October, said.

“A key element not addressed in counsel assisting’s submissions, however, which should also be considered by the royal commission, is provider culture.

“The government can regulate, set standards and change ­institutional arrangements but strong, positive, provider leadership and culture is essential to ­ensuring that the future aged-care system has the needs and preferences of older Australians at its centre,” it reads.

“The commonwealth raises this issue, not in an attempt to ­refute or divert attention from criticism of the current aged-care system, but to reinforce the point that improved funding, stronger regulation and new governance structures will not on their own ensure high-quality aged care.

“The importance of culture and the need for a commitment to quality care, have not, in the commonwealth’s view, explicitly been called out as core issues by counsel assisting.”

With the commission’s report due to be handed to the government on February 26, expectations in the sector are high for both the breadth of the recommendations and the government’s willingness to embrace it.

Last October, lawyers assisting the two-year-long inquiry gave commissioners Lynelle Briggs and Tony Pagone a final submission outlining their views on the system and 124 recommendations for improvement.

It described the aged care system as unfit for purpose, with one in five people in nursing homes receiving substandard care. The level of abuse in care settings was a “national shame”, they said.

As the commissioners’ report and the government’s ­response to it draws near, positioning in the sector has already begun.

On Monday, a coalition of aged-care providers announced a new political campaign targeting 15 marginal seats. They argue that Australia needs to be spending $20bn a year more on home care and on nursing homes to meet world standards in aged care.

The ageing population means 88,000 new nursing home places will be needed within a decade at a cost of $55bn. And 100,000 people are waiting for home support at their approved level.

Finding an appropriately skilled workforce to provide the care is another challenge in the sector. One of the most significant issues for the commission is whether to recommend staff-to-bed ratios in nursing homes.

The department endorsed the lawyers’ decision not to, but a key nursing group disagrees.

The Australian Nursing and Midwifery Association is pushing for mandated levels of care, recommending residents receive an average of 4.3 hours of care per day delivered 30 per cent by registered nurses, 20 per cent by enrolled nurses and 50 per cent by personal care workers.