For those of us that pay close attention to the aged care sector, hearing the news that an aged care home has failed to meet accreditation standards is nowhere near as shocking as it should be.
There has been no shortage of aged care facilities having sanctions imposed upon them for failing to meet the basic standards of care, and the penalties that providers face for these failures seem to be doing very little to stem the tide of accreditation failures.
The Australian population is ageing rapidly, and the expected influx of older people needing residential aged care around the country is going to put even more pressure on an aged care system that is already well past its breaking point.
We need to be asking those running the industry if the sanctions on aged care providers that fail accreditation are actually meant to be a deterrent, or are things actually so bad at this point that they are being forced to value the quantity of available aged care providers over only wanting those who provide high-quality care?
Dr. Rodney Jilek has spent over three decades working in various roles across the Australian aged care sector, but his current role as the Principal Advisor at Aged Care Consulting and Advisory Services has him providing advice to aged care providers who have failed aged care accreditation.
This role gives Dr. Jilek a unique insight into the mindset of aged care providers who have failed accreditation, and he sat down with HelloCare to discuss the validity of current-day sanctions as a deterrent for those who are failing to provide quality care.
“Sanctions used to be the worst thing that could ever possibly happen to you, and it was seen as the end of the line when the time came that the department had to impose sanctions on you,” said Dr, Jilek.
“All of a sudden we have had a string of sanctioned homes in the last couple of years, and the attitude of some of the providers is ‘ahh well, these things happen, we will get over it.’ It feels as though some providers think of a sanction as a momentary blip on the radar. This is definitely not a generalization of all providers though, because even though some may take this stance, there are others that are genuinely horrified”
“Placing sanctions on a provider can be the wake-up call that they need which prompts them to get their act together and put in the resources to fix things, but on the whole, I don’t see current sanctions really improving the lives of elderly Australians because the responses are too variable and there’s no consistent monitoring of the homes.”
“I can be working at a facility that has been sanctioned and the department won’t even come to this facility once over six months. They have a weekly telephone call where a CEO can tell them anything they want.”
While the types of penalties that can result from a failed accreditation can vary, sanctions being placed on aged care providers usually last for three months and consist of making a facility appoint both a nurse advisor and administrator to oversee operations.
Failure to improve after this point can result in the revoking of ‘approved provider’ status, thus becoming ineligible to receive Commonwealth funding for new residents until sanctions have been lifted.
Despite all the talk of transparency in aged care, according to Dr. Jilek, the process of handing out adequate penalties for failing accreditation is shrouded in mystery.
“You have homes that fail two or three outcomes that are being sanctioned, and then you have others that are failing 20 outcomes who haven’t been sanctioned. There is absolutely no rhyme or reason as to who gets sanctioned and why, and each sanction comes down to the decision of one person – a health department delegate,” said Dr. Jilek.
“There are all sorts of questions that need to be asked about the relationship between every delegate in each state and the peak bodies and aged care providers that they deal with because the whole thing is extremely murky and there is no transparency at all.”
“Even when they decide to impose sanctions, that information is not available on their website for a couple of months. It’s all cloak and dagger stuff.”
“The time that sanctions last has been cut in half, providers get extensions on the time periods in which they have to bring things up to speed, and they even pick their own advisors, despite the fact that they failed to manage themselves in the first place.”
“It’s actually mind-boggling that the delegates in the Health Department can think to themselves ‘yep, this place failed accreditation horrendously but let’s trust them to fix things themselves.”
There have been a number of examples in the last year of aged care providers failing accreditation, and then managing to pass accreditation and have their sanctions lifted, only to fail accreditation again soon after.
From a distance, this would seem to suggest that some aged care providers are looking for a short-term solution in order to regain accreditation, rather than getting to the core of the issues and committing themselves to make positive changes.
According to Dr. Jilek, each provider responds to the news of a failed outcome differently, but reducing the imposed time of sanctions has removed the only real power that they actually possess.
“I don’t think that we have a lot of providers taking these sanctions seriously,” said Dr. Jilek.
“Sanctions used to be for six months, and they have been watered down now to three months in most cases. The department will say that the reason for that is the financial impact that this has on providers, but the financial impact is the only actual deterrent.”
“We have seen a number of providers who have no intention of fixing the issues at the root cause and instead push for band-aid solutions that mask the problem and are unsustainable. It is our experience in NSW that this approach is being allowed by the Department of Health and even when ongoing risks are raised with them by nurse advisors – they are being ignored.”
“The department, and the government more broadly, need to work out if they are serious about getting rid of aged care providers who are incapable of meeting the minimum standards of care for elderly people – because, at the moment, its seems that they are more interested in quantity than quality.”
Individual interpretation has long been the difference between meeting a Standard and failing.
The Standards are misunderstood by the public, a facility can be delivering excellent care with happy residents but fail on the documtation and that demonstrates that the decision makers are much more interested in the documentation rather than actual care.
The aged-care industry is a document mess, it’s ludicrous to have a national standard and not have standardised documents. The actual format needs to be carried through each and every facility if we want to limit bias and misinterpretation.
The unsaid part of the above story is just as important. Facilities are meeting 44/44 and failing 18-20 a few months later. How can you explain this, how can it happen? Does the facility just stop doing good work or do the assessors get scrutinised upon return to the office and another team sent out… more likely.
To suggest that sanctions are not a deterrent is ludicrous but with the new aggressive manner of assessing providers feel that sanctions are pretty much inevitable and they haven’t felt this previously. Aged care used to be team work, from the department through to the AIN where direction was the norm. That has gone and assessors will declare a standard failed but refuse to offer a solution or remedy saying that they don’t want to be “prescriptive” but that is exactly what is happening.
Sanctions are a major deterrent especially to an industry that has been deliberately and dangerously underfunded by the government. Beside the loss of future income the real and immediate impact is the half a million dollars that it will cost to reinstate standards. How does the government and industry bodies justify the cost, both have access to specialist people that can hopefully get a facility on the right track but how do they justify the half million dollars for six months part-time work? The government, if it was genuine in wanting to fix rather than punish would set a maximum rate for this service rather than the gouging of present.
The last comment being quantity over quality is offensive. The vast majority of facilities offer excellent service and care and like it or not Australia is going to need quantity and lots of it.
How about instead of these repetitive and I’ll informed opinion pieces why doesn’t the media start to ask the government when they are going to fix residential care funding? That is the real problem with the industry, “people going broke make poor decisions”.
Dear Anton, I’m very sorry that you feel the aged care sector are being very poorly treated in this current era. I feel terrible that you think it is everyone else’s fault than the aged care sector itself. It must be terrible for you to have to read these harrowing accounts of how the aged care sector is being treated. No wonder you can’t see what is happening to some of the most vulnerable folks in our society, your distress at how the aged care sector is faring must be overwhelming you.
Clearly your priorities are correct, we must begin to look after the operators of our aged care facilities, they are clearly suffering in this current era of attempts to improve care to our elders.
Disclosure: my comments may be influenced by the fact that my father is not provided basic care needs in a facility that has been recently sanctioned AND whose CFO is to be an ‘expert’ speaker on the running of aged care facilities at an upcoming conference! This industry has no shame. My bad.
The reality is that most of the senior staff in our aged care regulators think their job is to make aged care work smoothly for providers.
This is not surprising because the Royal Commissions into child abuse and banking have shown the same problems with regulators.
We need consumer representatives at every decision making level in the regulators. Real families having input, not regulatory staff with a new title.
If you want to have a board of directors to include residents or relatives that have zero management or financial knowledge. Have zero experience or knowledge of the industry then why don’t you buy a facility?
Would you want people with possibly a grudge or bias on your board? These people wouldn’t care what the cost is…. just spend and spend.
Individuals like myself have been in the industry for 40 years and like it or not it’s a mess. A mess, again like it or not, that has been made by the government. There are sad cases but there are bad things happening in every aspect of the world. We can’t condemn the whole for a rotten part.
If you are unhappy with the care where you are then either move or volunteer. See how much care is out there.
There is so little knowledge of the facts in the community so if you dig beneath your distrust and have a look about we will all be the wiser.
I’m happy to show you how real care is delivered on a daily basis in the majority of instances around the country if you want.
Jack, I m sure your sarcasm is based on your unfortunate but limited experience.
It doesn’t matter if you run a nursing home or a fish and chip shop, if your customer (the government in our case) doesn’t pay properly for goods or services those services deteriorate AND that affects residents.
I understand that you have read something and that you had what you think was substandard service at the one facility you have ever wandered into but to arrogantly or perhaps ignorantly to condemn an entire industry is foolish.
My piece conveyed that facilities are struggling financially, forget the nonsense some disgruntled individual may have written about huge profits and sports cars. The fact is that for the very few operators that made a profit only received – 05% return.
These people have invested considerably in the delivery of care and have been attacked by a government that has made no preparations for the ageing population and a media campaign to malign.
At some stage you might think about it and (doubtfully) understand that the delivery of care is reliant on money.
No money… No care… So have a look at the facts and see where the problem stems from.