Mar 28, 2019

Lessons for aged care from the Royal Commission into Child Sexual Abuse

Royal Commissions present an opportunity to overhaul cultures and policies, and to create change for the better, not only in the present, but into the future. They have the power to reframe how we think about society and culture, and they are an opportunity for people’s stories to be heard.

Lisa Giacomelli, chief operating officer of the YMCA NSW, has spoken to HelloCare about her organisation’s experiences with the Royal Commission into Institutional responses to Child Sexual Abuse, which she says has a number of parallels with the Royal Commission underway in the aged care sector.

Ms Giacomelli said the Royal Commission into Institutional responses to Child Sexual Abuse “laid the bedrock” for how we treat some of the “most vulnerable” members of our community, and she expects the Aged Care Royal Commission will do the same.

Royal Commission an opportunity to create change for good

The Aged Care Royal Commission will force communities to think about how we treat older people in society, Ms Giacometti said.

“How do we value them better, and how do we give them experiences that reflect the value that we put on them as a community and as a society?” she said.

The Royal Commission into Institutional responses to Child Sexual Abuse changed not only her own organisation, but the way organisations and societies deal with child safety around the world, she said.

“If you can get past the fact that it does feel… overwhelming or there can be a sense of threat or a sense of feeling there is some uncertainty in it…, you’re actually contributing to what will ultimately be a change for good,” she said.

The importance of good leadership

The most important lesson the YMCA learned from the Royal Commission is the fundamental role that leadership plays in quality of care, Ms Giacomelli said.

Leaders have to “understand what their responsibilities are” and “be in the business enough” to understand what that responsibility looks like on the ground.

Do staff understand the policies and procedures?

Another key lesson was the importance of having the right policies and procedures in place, and ensuring they are clearly written in plain English and understood by all staff.

“The policy and procedures are only as good as the understanding staff have about how they should operate,” Ms Giacomelli observed.

Those in care should be at the heart of the organisation

The vulnerable people in an organisation’s care should always be at the centre of everything the organisation does, Ms Giacomelli said.

“For [the YMCA], putting the safety of children at the centre of everything we do, every decision we make, enshrining that in policy in our values and culture was really, really important,” she said.

Royal Commissions create an ongoing process of improvement

“The other lesson for us was that this is perennial,” Ms Giacomelli said. “You don’t come out of a royal commission and tick a whole lot of boxes and say we’re done here,” she said.

Royal Commissions are not about punishing people who have done the wrong thing, they are about “giving a voice to the most vulnerable”, Ms Giacomelli said.

“They are about shining a light on systemic issues that need to be addressed to ensure that those most vulnerable in our communities are looked after.”

Look at the service through the client’s eyes

Ms Giacomellii said one of the YMCA’s main learnings was to try to look at the organisation through a client’s – a child’s – eyes.

“What does it mean to be a child in our service, what does it mean to feel safe, secure and protected?” she asked.

Ms Giacomelli said though complying with the requests of the Royal Commission were onerous, they always felt their requests were reasonable. Questions were always answered, and the process was extremely well managed.

The YMCA restructured “from head to toe” after Royal Commission

The YMCA introduced an extensive range of changes in response to the Royal Commission into Institutional responses to Child Sexual Abuse, Ms Giacomelli said.

The Royal Commission resulted in “a complete review of our policies and procedures and a complete review of our culture and values,” she said.

“We established a project management office that was responsible for rolling out the responses to the findings, and we restructured the organisation from head to toe.”

“We resourced it very very heavily, both in terms of structure and systems and process, but also in terms of working to have the right people in the right roles,” she said.

New human resources information system were put in place to better manage recruitment and training.

New software systems to manage risk were introduced. “We introduced an extended risk capability within the organisation that looked at child safety specifically, but also we looked at risk across the business.

“Because if you blur a boundary on something little, you can blur a boundary on something big,” she said.

Lessons for aged care

Ms Giacomelli said she expects to see wide scale recommendations come out of the Aged Care Royal Commission for the sector.

“You can already see some of them coming out in the research papers that are coming out of this Royal Commission,” she observed.

“I think there will be some recommended changes to industry practice and systems across the sector that organisations will need to take on board.

“My advice would be to start early.

“For organisation in the aged sector, my advice from our learnings would be get ahead of that curve.

“You’ll see the commission publishing research. You’ll see the commission publishing the documents on where its thinking is going.

“That will give agencies a really good idea of what those recommendations might be.”

The power of speaking up and talking about the unspeakable

“The great benefit of the Royal Commission we were in, was that it allowed community, and society, to talk about things that were unspeakable.

“It put a human face on something that needed to be put into the sunlight,” Ms Giacomelli said.

“It enabled us to talk about things as a community and as industries and as sectors that previously made us really uncomfortable and the value of that for survivors, the value of that in terms of the safety of children going forward is immeasurable.”

Similar changes will occur in aged care, she said.

The Royal Commission sends our society a message about speaking up, Ms Giacomelli said, and “the role people have when they are responsible for the most vulnerable in our community.

“It is incumbent upon them to take every step they can to ensure those people are treated with dignity and respect and safety and care.”  

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