Aged care oversight and regulation should be removed from government control, so long as no aged care providers or peak bodies have roles on governing bodies, an aged care expert has proposed.
Peter Vincent is Managing Director and Principal Advisor of Aged Care Management Australia. With decades of experience, he has visited and consulted in aged care homes all around the country for years.
Vincent told HelloCare he is “leaning towards” Commissioner Pagone’s recommendation from the royal commission to take aged care regulation away from government, on the proviso that no providers or peak bodies have roles on boards or governing bodies.
“Pagone’s position is why let someone who has continued to break the system, manage it into the future in a new framework. I think there’s a lot of merit in that,” Vincent said.
He would be “concerned” if the peak bodies or aged care providers were involved in leadership of the new Australian Aged Care Commission, because they have too much self interest. Vincent cited the example of Stirling Giff’s Bill to improve the transparency of aged care funding, which the peak bodies “resisted and lobbied hard against”.
If the Aged Care Pricing Authority was folded into the new Australian Aged Care Commission, Vincent said that would provide a “starting structure” for “rebuilding” the Aged Care Act.
Vincent says he is in favour of removing the role and function of the Aged Care Quality and Safety Commission, expressing his concerns to HelloCare bluntly.
“I don’t believe that it’s been effective and I don’t believe that it has the confidence or the support of the industry,” he said.
The Aged Care Quality and Safety Commission’s philosophies and practices are based on WHO best practice, but it’s their execution that has failed.
“The culture within the current aged care quality and safety commission is not good,” Vincent observed.
“The way the commission approaches organisations that have compliance issues is so variable” and in some instances is “extremely aggressive”, particularly in South Australia and Western Australia, Vincent said.
The Commission has a “very small hierarchy and they’re not able to control the vast number of people they employ to execute their assessments and their site visits.”
The new standards don’t help, as everything measured is subjective, Vincent observed.
Australia’s aged care system should use the same method of quality assessment used in acute healthcare. “The aged care sector has to come under the primary health service model,” Vincent said.
Prior to the current Aged Care Quality and Safety Commission, the Quality and Compliance Agency employed experienced registered nurses who would do “random, friendly visits” to facilities and “sit and talk with providers and listen”. Vincent would like to see a return to this practice.
“They had the skills to identify [issues]” and they had the “legislative capacity” to go through medication charts or palliative care documentation.
Of course, these matters are hypothetical until the government determines which path it will take. The industry will be watching closely.
The Aged Care Quality and Safety Commission issued a statement saying, “Reform is already underway in a number of areas identified for attention by the Royal Commission.”
“We will continue to work closely with Government agencies and other key stakeholders to deliver on the Government’s reforms and plans for the aged care sector.
“All staff in the Commission share a strong commitment to ensuring that older Australians receiving aged care are safe, well looked after, and have a good quality of life.
“We work to achieve this objective by holding approved providers to account for meeting their legal obligations, including in relation to providing safe, quality care and striving to continuously improve their performance and outcomes for older Australians.”
HelloCare contacted the Australian Aged Care Collaboration before publishing. They provided a stock statement but did not answer our questions.