2018 must be a year of action in aged care

Leading Age Services Australia (LASA) is working in close partnership with the government on the reform agenda for aged care. The spotlight is now firmly on how the government responds. 2018 must be a year of action if the industry is to move forward.

At LASA, we are committed to working with our members and the federal government to resolve fundamental issues relating to the four key and interrelated policy pillars of access to services, funding of services, quality of services and delivery of services (that is, ensuring workforce capability and supply).

LASA’s 2018–19 Pre-Budget Submission is extensive and includes 15 recommendations for government to consider as it prepares its Budget due for release on 8 May.

Our recommendations are informed by observations which include:

• The growing impact of recent Aged Care Funding Instrument (ACFI) changes and the indexation pause on residential aged-care financial performance. These changes, combined with the growing complexity of residents’ needs, changing consumer and family expectations, and increasing operating costs, are placing increasing financial pressure on residential care providers. These issues are particularly serious in rural and regional settings, where viability is being seriously threatened.
• Based on the 2016–17 Aged Care Financing Authority Annual Report, approximately 30% of residential aged-care providers operated at a loss. Other financial pressures on providers, including a 3.3% increase to minimum wages, are expected to contribute to further decline in financial performance over time.
• The need for a multipronged response to the growing national queue for home care packages, which sees 101,508 consumers awaiting services as at 30 September 2017.

LASA’s budget response

In developing our budget response, LASA has drawn heavily on member feedback derived from processes including the LASA submission to the Tune Review, member advice on home care reforms, LASA’s own home care surveys, and our recently completed survey of our members’ CEOs.

David Tune’s report on the Legislated Review of the Living Longer Living Better (LLLB) reforms, released in September 2017, also supports many of our assertions around sector financial sustainability. Most notably the report states that:

• Meeting projected future demand will need additional investment by government beyond that currently planned
• Current planning mechanisms are not going to deliver sufficient services in the long term
• A key issue is how increased demand will be financed and the costs shared.

Independent financial modelling by respected industry analyst Stewart Brown has also identified the urgent need to address funding issues in both residential aged care and home care.

LASA believes that all potential resourcing solutions should be on the table to inform a mature and open national conversation. Any approach to funding must receive bipartisan support, as this is too important not to get right. To this end, LASA aims to engage with government and the community to progress this conversation of national importance.

New industry standards

Quality of care within the industry continues to be our highest priority and we welcome the new draft Aged Care Quality Standards released by the Department of Health on 30 January 2018.

These are a single set of quality standards that will replace the existing Accreditation Standards, Home Care Standards, National Aboriginal and Torres Strait Islander Flexible Aged Care Program Quality Framework Standards and Transition Care Standards.

Subject to agreement by the government, the new standards are expected to be implemented from 1 July 2018. A 12-month transition period will apply, meaning that assessment against the new standards will commence from 1 July 2019.

LASA has sought funding from government to support providers to implement the new standards and is currently considering a program of activities to support members in this transition.

These standards may be impacted by accreditation system and process changes resulting from quality inquiries like the Carnell Paterson Report, such as the move to having unannounced visits replace announced reaccreditation visits.

Collectively, we need to translate these developments into appropriate actions and outcomes that will address identified shortcomings, as well as contribute to continuous improvement and community confidence.

LASA’s commitment to ensuring this outcome is emphatic, as our country needs an accreditation system that assures the community of the safety, wellbeing and quality of life for older Australians living in residential aged care.

It is comforting to know that Australia’s current quality framework is resulting in most Australians in aged care and their families receiving high-quality care, support and services that meet the most stringent national standards.

Of course, quality and standards in aged care are intrinsically linked to the industry’s workforce.

Improving staffing ratios

LASA believes that the ongoing debate around staffing in aged-care facilities would be better served by focusing on the quality of outcomes for older Australians rather than mandated staffing ratios.

Notwithstanding recent public commentary regarding staff-to-resident ratios, quality of care is not as simple as the number of staff on duty or arbitrary staffing ratios. The basis for deciding on staffing levels and their skills mix needs to be driven by the actual care needs of individual residents.

Flexibility to adjust the staffing mix as the profile of a facility’s residents change is a very important consideration and I believe we risk losing sight of this in the current debate.

LASA has welcomed the opportunity to work with the federal government’s Aged Care Workforce Taskforce, headed by Professor John Pollaers, which is responsible for developing a wide-ranging workforce strategy focused on supporting safe, quality aged care for senior Australians. The taskforce is expected to complete its work by 30 June this year.

Four core principles

The aged-care reform agenda in Australia is predicated on four core principles: ageing in place; consumer choice; market-based competition; and consumer contributions. LASA recognises the critical importance of this agenda to ensure that accessible, affordable, quality care and services are available now and into the future and seeks to shape a proactive and pragmatic approach to driving sector reform, performance and sustainability.

The Commonwealth Government has said it is considering a number of inputs in developing further aged-care reforms, with links to the budget process. If we seize this opportunity it will be seen as a seminal moment where new foundations were laid for Australia’s aged-care system to meet the needs of older Australians for decades to come.

The spotlight is now firmly focused on how the government responds. The industry has worked in close partnership with the government on the reform agenda to date. Expectations are set that 2018 must be the year of action.

*Sean Rooney is the CEO of Leading Age Services Australia (LASA).

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