Part of the government’s historic $17.7 billion aged care package announced last year in the Federal Budget was a $10 per day supplement to the Basic Daily Fee directed at delivering better care and services, particularly targeting improved food and nutrition.
The royal commission had revealed that as many as 68% of aged care residents were either malnourished or at risk of malnutrition, and heard that 2017 research by aged care food experts, The Lantern Project, revealed the average daily spend on food for residents was about $6.
While the Royal Commission recommended a $10 per day per resident permanent increase in the Basic Daily Fee, the supplement introduced by the government has to be applied for every quarter.
Payment is also conditional on providers reporting quarterly to the Department of Health about their food and nutrition spending.
Providers must report on spending on food and ingredients, pre-prepared meals, oral nutritional supplements, chef hours, food service staff hours, and allied health support, such as dietitians, speech pathologists and oral health practitioners – which Aged Care Services Minister Richard Colbeck has informed aged care providers they will no longer receive funding specifically earmarked for.
“The federal government believes aged care homes are wasting money on allied health services such as physiotherapists, which will no longer be directly funded under new rules,” The Sydney Morning Herald reports.
Providers have now been receiving the supplement for nine months, so the team at HelloCare decided to take a look at how food services have improved in that time, if at all.
Provider’s spending a constant $13 per day on food
Anton Hutchinson, whose family has owned Canberra Aged Care for more than 25 years, said his aged care home has continued to spend around $13 per day per resident on food, even since they began receiving the supplement.
He said their current level of spending on food has changed little for as long as he can remember.
Mr Hutchinson believes the funds should have been paid automatically to providers, rather than them having to apply quarterly.
The reporting required for the payment isn’t onerous, Mr Hutchinson said. It’s simply a “tick-a-box” exercise – in line with the government’s desire not to place additional administrative burdens on providers.
“They’ve cut the guts out of cleaning”
When we asked them, members of HelloCare’s Aged Care Worker Support Group on Facebook gave mixed reports on whether food had improved over the last nine months.
“If anything it’s worse,” wrote one aged care worker.
Many of their residents rely on family to bring in food.
“If you don’t have family, bad luck,” she said. “If you don’t have family who regularly visit, then it’s three meals a day with the odd sip of fluid if you are lucky.”
The plight of residents with no family to help with meals and eating “breaks my heart,” she admitted.
Another aged care worker reported “no change” in the food the residents are receiving, or in the care delivered.
“No change in the quality of food except they do not get dessert after dinner now and many of them miss it,” someone else reported.
One said residents now receive a bread roll with their meals.
While another aged care worker said she had spoken to the head of their food services: “He was not even aware of the extra funding,” she said.
But some members of the support group praised the quality of the food they serve.
However, this member of the group said cuts have been seen in other areas of operations, including care.
“They have cut the guts out of cleaning and the amount of Personal Care Assistant hours on the floor,” she shared.
Providers spend $12.63 per resident per day on food
Grant Corderoy, Senior Partner with independent accountancy firm StewartBrown, told HelloCare the Basic Daily Fee is supposed to cover catering, cleaning, laundry, utilities and routine maintenance.
“The cost of providing those five things is greater than the Basic Daily Fee by about $10. Providers were supplementing that $10 loss … from their direct care subsidy,” he explained.
“Hopefully” the new Basic Daily Fee supplement means providers can put more funds towards direct care, he said – and the data seems to suggest this is so.
In 2018-19, the raw material component of food in aged care was $10.34 per resident per day.
In 2019-20, it was $12.50.
“That big increase you could almost directly attribute to the Royal Commission,” Corduroy observed. However, since then, there’s been a “flattening out”.
In 2020-21, aged care providers spent $12.58 on food, and in the last six months of 2021, they spent $12.63 per resident per day on the raw material component of food.
The total cost of preparing, cooking, and delivering food is $32.50 per resident per day.
Mr Corduroy said StewartBrown’s research shows the number of direct care hours has been steadily increasing over that period.
The quarterly reporting is also helpful, according to Mr Corderoy.
Providers that receive complaints about their food, or if they don’t improve the quality of their meals, run the risk the supplement will be cut off, he explained.
Eventually consumer feedback and complaints about food will be reflected in the new aged care home star rating system.
Currently, consumers on the My Aged Care site can see how consumers at the home have enjoyed the food. Under the Quality tab on My Aged Care, you can select ‘Do you like the food here?’ and see how consumers have responded.
Department will report later this month
A spokesperson from the Department of Health told HelloCare that later this month they expect to publish a Food and Nutrition report, based on data provided by aged care services that receive the Basic Daily Fee Supplement.
The data shows the average spend on food is above $10 per resident per day, the spokesperson said.
“Reporting also highlights a range of better practices in delivering food services, including consumer engagement strategies and the use of dietitians,” they said.
They also noted that from July 2021, residential aged care providers have been required to collect and report on the new Quality Indicators, including unplanned weight loss – where food may have an impact. This data is available on the GEN Aged Care Data website, but does not show the results for individual providers or homes.
Consumers who wish to find out the Quality Indicators of their home or a home they are investigating have to ask them directly – not exactly a transparent process.
The last word goes to Mr Hutchinson, who has always prioritised spending on food, but is sympathetic to other providers who have cut food expenditure in recent years.
With modern technology there is no excuse why the detailed breakup of all expenditure in Residential Aged Care Facilities is not available to Governments on line.
There should be no forms, no individual schedules and returns to complete.
These are not private business’s, regardless of their claims otherwise. They are totally dependent upon Australian Government funding for survival. If they want the money, and the profits it clearly brings to some of them, they should do exactly what is required to deliver total transparency. All Residential Aged Care Facilities should be given 3 years notice to move to an open source data transfer/reporting system. This should reveal all, even to regulators who are reluctant to regulate.
There are a large number of “Yes Minister” videos on line that should be compulsory viewing for Age Care Regulators. Make some decisions and get on with it. We have waited long enough.
Max, with your history you should know better than this.
Private nursing homes are private businesses and they contract their building and skills to the government.
As to transparency,do you have any idea how the present Independent Auditors lodge their reports each and every October? I think you will find they have been lodged electronically for many years.
Those yearly reports clearly detail where every dollar is spent and how it is spent which is the transparency you seem to believe doesn’t exist.
The government’s own ACFA produce a report that is available to anyone really interested, No 8 was the most recent and it clearly states that the sector is unsustainable.
Why don’t you ask the government why they don’t publicise the report findings.. obviously it would clearly show that the government has failed it’s duty of care to provide adequate funding for the safe and sustainable delivery of care to elderly nursing home residents.