Jun 28, 2018

An Agenda for Change in the Aged Care Industry

HelloCare Exclusive – This is the final article in a series of 4. Read Part 1, Part 2, and Part 3.

The Aged Care Workforce Strategy Taskforce will deliver its findings in a report to the Minister for Aged Care, the Hon Ken Wyatt, this week.

The strategy includes pragmatic actions to better support the workforce in their essential role of caring for older Australians.

In my first article for HelloCare readers, I explained the Taskforce’s community consultations, strategies to address negative stigmas attached to ageing, and developing an industry code of practice.

In the second article, I looked at the Taskforce’s proposals to develop new career pathways in the rapidly evolving and expanding aged care sector.

And in the third article I looked at implementing industry standards for workforce planning, better integration between primary, acute care and aged care, and establishing a Remote Accord to support the special needs of the aged care workforce in remote communities.

This final article is about creating mechanisms for industry, government and the community to get together to enable real change to the system.

Transitioning the workforce to new standards

Bringing about sustained change requires strong leadership from industry; cultural changes require visible industry leadership with a unified voice.

The taskforce is recommending the establishment of an Aged Services Industry Council to provide the strategic leadership necessary to implement key aspects of the workforce strategy.

The Council would consist of provider CEOs from each of the three industry peak bodies – ACSA, the Aged Care Guild, and LASA – as well as unaligned provider groups. Cross-industry sub-committees would also be established.

One of the first priorities of the Council would be to establish a voluntary code of practice to drive cultural change (see Part 1 for more information about the Code).

The Council would also liaise with the new Aged Care Quality and Safety Commission , and would be expected to establish a leadership group to design and oversee initiatives and implement key aspects of the workforce strategy. The council would also promote the voluntary code of practice to providers and develop good practice guidance material to explain the application of the code and support its adherence. The Council would establish a complaints capability and work closely with the Aged Care Complaints Commissioner to establish protocols and processes for both complaint handling and information sharing.

Ministerial Council

While there are some aspects of the workforce strategy that industry can take the lead on, others will require a concerted effort by government.

If we are sincere in our desire to put the quality of life of consumers at the heart of the aged care system, we need real change in the way we as a nation organise and fund aged care.

I see a pressing need for a cross-jurisdictional Ministerial discussion, to bring together all levels of government to align care around consumers. The continuum of care, across the system, needs a whole-of-government commitment so we can address issues like funding and ease of access to services.

We know that most people prefer to stay in their homes for as long as possible. We all need to work together so this is a reality for more people, and so that those caring for the elderly – families, carers, trusted entities – are better supported in the valuable role they play.

Aged care needs to be part of a national conversation. We need all levels of government, industry and the wider community to be part of that conversation if we are to bring about transformative change.

Establishing an Aged Care Industry Growth and Research Translation Centre

We can also improve the quality of care by making better use of innovative products and services.

An Aged Care Centre for Growth and Translational Research would support the translation and uptake of innovations to drive improvements in aged care service delivery and workforce capability. It would formalise collaborations between end users, researchers, investors and workforce educators to help take research from conception to market.

The Centre would be a research eco-system that would help ensure research is needs-based and outcomes focussed, and provide a single voice on funding priorities. It would leverage public-private investment, ensure effective knowledge transfer and attract private investment into aged care research.

…and finally

I would like to thank everyone who has contributed to the development of the workforce strategy. We now have an entire program for execution, which is executable within three years, and sets the industry up for the next 4-7 years. With the workforce strategy, and a concerted effort by industry, government and the wider community, we can deliver the transformational change required to bring together a unified industry, with one voice, to achieve a common goal – caring for the aged.

Aged Care. How we care is a reflection of who we are.

By Professor John Pollaers OAM.

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  1. Older people should receive care from providers that actually provide the care that they need instead of taking money with one hand and rationing care with the other. To add insult to injury some of these transnational companies are taking their profits out of Australia and into tax havens. No one in Australia benefits from the current arrangements except shareholders who buy and sell this misery on the stock exchange. These private corporate Aged Care providers are rorting the visa system to use ‘trainees’ instead of paid Nurses and have replaced Nurses with PSAs some of whom can barely speak English and are not suitable to care for vulnerable older people. The current situation is appalling and can only be fixed when Nurses are reintroduced into Aged Care, shonky providers are shut down and corporate providers are made to provide the care that people are paying for.

  2. An industry council led by the usual CEO’s from the big providers is going to send us once again down the same path. These guys largely do a good job, but the cannot possibly replicate the close knit communities which small, not for profit providers do well. A balance is required to ensure all older Australians can access care which is right for them. I receive many comments from residents and families who have been in or stayed in other homes belonging to big providers, and the comments are always the same. They “feel” like hotels or hospitals, and have no “soul”. So, depending on what you want from a provider, surely those that succeed in providing a true “home”, are equally as important?. I for one do not wish to have the future of my home decided by suits on huge salaries who won’t ever have to worry about care when they are older….

  3. Professor Pollaers is a decent person and is doing the best he can but he is working within a system of which he is a part. It is incapable of addressing the core problems because this challenges the patterns on thought on which that system is built. Like any powerful group they are unwilling to release the control they have over the system and of government. Put simply the sort of market we have is unsuited to the sector and we will very probably be back to square one within a few years of these reforms. Handing the problem to the industry to solve made it unsolvable.

    Care of the vulnerable has always been a community responsibility and we are all responsible for helping those in trouble around us. When others assume that role they are agents of the community. In ‘Agency theory’ the community is the ‘principle’ and responsible for ensuring that their agents, government and providers, provide the sort of care the principle would if they were able to do it themselves.

    The communities should therefore be the primary controlling entity in society managing aged care – yet they have been pushed aside as central government and businessmen have taken control. It has not worked and, as recent failures have shown this is because government regulators are not regularly on site. They are incapable of regulating in the face of the strong commercial pressures that such a competitive system has created. What Pallaers is proposing is a sop and falls a long way short of empowering the community so that it can fulfil its role as ‘principle’.

    The Public Guardian in Queensland is advocating for an empowered visitors scheme. Aged Care Crisis strongly supports that but considers that the visitors should be drawn from local communities, be supported by local medical nursing and medical expertise, and be the nucleus for a community based structure which government would support. They would work cooperatively with residents, families and local providers of care and be in a position to immediately and directly address any issues.

    Government would deliver and integrate an increasing amount of its oversight, regulatory, complaints handling, advocacy and organisational activities through local communities and provide backup. The most effective first line of regulation is the interaction that we have with one another as we talk about care. It maintains values and changes unsuitable cultures.

    This interactive form of regulation has been undermined and our communities have been eroded by the changes brought about during and since the Reagan and Thatcher era. This would be a step in rebuilding them.

    What seniors and their families need is someone who is there for them at their time of need. What this market needs is a supported and so effective customer, as well as a community that ostracises and ejects those whose conduct is unacceptable.

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