Mar 25, 2021

“They’ve got to do something”: Regulatory action fails to fix problems in aged care home

Sad elderly lady

In their final report, The Royal Commission into Aged Care Quality and Safety commissioners said the body has “not demonstrated strong and effective regulation” and is not focused enough on outcomes for older people. 

They recommended for the regulator be abolished in its current form.

Two assessments: Declining performance

In an assessment of the home conducted in June 2020, the Aged Care Quality and Safety Commission identified one failing in each of the personal and clinical care and organisational governance standards.

The assessment team wrote: “Consumers with challenging behaviours have not been managed to minimise harm or threats to their safety or wellbeing. 

“There was evidence of unauthorised use of restraints.”

The team also identified “abuse and neglect of consumers”.

During the October 2020 assessment, two failings were identified in personal and clinical care, and one in organisational governance.

This time the assessors wrote: “While the Assessment Team acknowledged that efforts have been made to address deficiencies identified during the performance assessment report dated 15 June 2020, the team identified several issues requiring further attention, including allegations that consumers have been subjected to unreasonable use of force or have been physically assaulted, complaints related to personal and clinical care for consumers, use of restraint, pressure area care, and pain.”

Further regulatory action may occur

A statement to HelloCare attributed to Janet Anderson PSM, Aged Care Quality and Safety Commissioner, said the commission will continue to “closely monitor” the home through regulatory action and complaints resolution activities.  

With the service’s accreditation expiring in August 2021, the regulator will complete a “comprehensive” unannounced site audit prior to then. 

“Should the Commission have ongoing concerns about the care and services [at the home], the Commission may consider further regulatory action or sanctions,” Ms Anderson said.

Financial pressures lead to cost-cutting

Compounding the pressures on the home, Jilek believes it is operating at a significant financial loss, and has consequently implemented “penny pinching” measures, such as cutting staff numbers and reducing air-conditioner use. 

“It’s a recipe for disaster,” he said.

Jilek believes another operator is unlikely to purchase the home, but at the same time, the government will not want to see it close. The home caters to a specific demographic and is a one-of-its-kind in the state – not to mention the fact that it is home to dozens of residents.

Little capacity to create change

Jilek said the regulator needs to create change at the home, but in his view it is unlikely to do so successfully.

Delegates of the regulator have themselves told Jilek to move the resident he knows to a different home, rather than await improvements.

A lost opportunity

The new standards were designed to be more transparent, consultative and to engage consumers, but the regulator gave consumers little opportunity to engage with the process during the matters described in this article.

Families were only notified of the regulator’s visits after they occurred, and they were therefore deprived of an opportunity to speak to assessors. 

“It’s a lost opportunity” for families to provide feedback to the regulator about the consumer’s experience of the home they are assessing, Jilek noted.

“More rigorous monitoring and investigation required”

The aged care regulator, which has only been operating in its current form since the start of last year, has come under increasing pressure over the last 12 months.

The Royal Commission into Aged Care Quality and Safety put it plainly.

“We both consider that the Aged Care Quality and Safety Commission and its predecessors have not demonstrated strong and effective regulation,” the commissioners wrote in their final report.

“The regulator adopted a light touch approach to regulation when a more rigorous system of continuous monitoring and investigation was required …  

“The regulatory framework is overly concerned with processes, not focused enough on outcomes … 

“The system is insufficiently responsive to the experiences of older people … 

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  1. The Aged Care Quality and Safety Commission needs a revamp.
    The tick-box style of requirements are completely out of kilter with what is needed.
    Sure we need systems, but mostly we need common sense.
    Employ more staff, ensure fair staff-consumer ratios. Employ properly trained staff and have ongoing on-site “relevant” and easily accessible education with in-house auditing for compliance.

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