Inquiries and reports into the state of aged care in Australia have often either not been acted on, or not acted on fully or quickly, the Royal Commission into Aged Care Quality and Safety has heard.
- The commission heard successive Australian governments have shown a lack of willingness to commit to changes recommended by numerous inquiries
- Senior counsel assisting the inquiry Peter Gray QC told the commissioners that implementation of change had been patchy
- The commission’s final report is expected in February
Counsel assisting the royal commission on Friday made their final submissions at the end of the two-year inquiry.
The commission has heard successive Australian governments have shown a lack of willingness to commit to changes recommended by numerous inquiries into and reviews of aged care over more than 20 years.
Senior counsel assisting the inquiry Peter Gray QC told the commissioners implementation of change had been patchy.
“And when one reads those responses carefully, one sees that some of them only partially address recommendations, sometimes under the guise of some fanfare that the recommendation will be implemented.
“One needs to look very carefully at the detail, when it comes to government responses to recommendations of inquiries into aged care.”
Thousands of people have made submissions to the aged care royal commission, and it has heard reports of violence, abuse, neglect and malnourishment in Australian aged care homes.
The counsel assisting team has made 124 recommendations, including for new laws based on human rights principles for older people, mandated staffing ratios, an independent aged care commission and that wider enforcement powers be given to the aged care regulator.
“Our recommendations … call for sweeping reforms to the system in order to address what we have identified as pervasive systemic problems,” Mr Gray said.
Mr Gray said the people at the heart of the system — those receiving care, the aged care workforce and the close supporters of those receiving care — needed to be heard.
More staff needed
Sinikka Heikkila from Tasmania saw her parents’ health decline after they were each diagnosed with dementia.
Her father spent two months in an aged care home in Hobart, and her mother was later cared for in the same home for about 18 months, before she died in August.
Ms Heikkila said she was very happy with the care her parents received, but the former nurse said caring for people with dementia was challenging.
“I just felt that you need more staff in those areas,” she said.
Better standards for dealing with dementia was among the issues raised on Friday.
“Dementia is so important to … almost every aspect of our recommendations,” Mr Gray said.
Among the recommendations are tougher restrictions on the use of anti-psychotic medications.
“In the future, the system should never again be involved in, and the community should never be confronted by, this apparent resort to the use of anti-psychotics in the place of proper care,” Mr Gray said.
Broader powers for the regulator to crack down on non-compliant aged care providers have been recommended, along with pricing reforms and immediate funding for more staff training.
During Thursday’s hearing, it was revealed 50 people in residential aged care in Australia were sexually assaulted each week.
The commission heard that figure was the best estimate because some alleged assaults were not reported, such as those where the alleged perpetrator was a fellow resident and had a diagnosed cognitive or mental impairment and the aged care provider had put in place arrangements to manage the alleged perpetrator’s behaviour.
Dental scheme for seniors recommended
The commission also heard older people were far more likely to have poor oral health which had adverse consequences for their health and social lives.
The counsel assisting team has recommended a seniors’ dental benefits scheme be part of improved access to allied health services for older people.
Mr Gray said the scheme should also provide dental care for older people who are not in aged care but who cannot afford it.
The commissioners thanked all of the people who shared the stories as part of the inquiry.
“In a very real way, we have moved forward together and, counsel, I’m confident that we will change the landscape of aged care in Australia,” Commissioner Lynelle Briggs said.
“After two years of evidence, it’s clear to me that we have an underfunded system that demonstrably fails to meet community standards of health, personal care and sustenance for a generation of people who are used to just making do.
“The system is not good enough for them and it is unimaginable that future generations will stand for it as it is. It is unacceptable to us all.”
Mr Gray said the proposed recommendations would require careful planning and careful implementation over a lengthy period.
“This has to be done deliberately and with relevant safeguards and, we would say, also with reporting of progress,” he said.
The commission’s final report is expected in February.