Submission to the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia

We hope that this Inquiry will complement earlier reviews and inquiries into issues of quality in the aged care system and will look forward to making systemic improvements, including as recommended by the Review of National Aged Care Quality Regulatory Processes.

Over the past two decades, COTA recognises that substantive improvements have been made to the quality of residential aged care due to both the Accreditation Scheme and other efforts. We note that of the 2,669 residential aged care facilities in Australia non-compliance across the sector is relatively low.

While acknowledging that the majority of aged care providers consistently deliver good quality care, COTA Australia remains concerned that poor practice in some providers continues to go undetected. This not only has a traumatic effect on those who are subject to poor quality care but also on their families and friends. It also has an impact on consumer confidence more broadly and the reputation of the sector as a whole. Some of the allegations in the media over the last twelve months of incidents in a number of residential aged care facilities, coupled with the events at the Makk and McLeay wards at the Oakden facility in South Australia, are especially concerning.

Nevertheless, improvements can be made to ensure poorer performance is identified and responded to sooner than is currently achieved through the regulatory system. For some time, we have held concerns that the accreditation system has lost some of its edge and that some providers have become skilled at the practices required to pass accreditation, resulting in more than 98% of facilities achieving an accreditation pass rate in 2017. While a focus on passing accreditation is to be expected, in some facilities across Australia we believe this does not flow onto (or in some cases, reflect) normal practice outside the accreditation period.

In addition, many Australians whom COTA speaks with worry that the practice and acceptance of low quality care by some providers can underscore a poor organisational or staffing culture, leading to lack of proper care for consumers in the longer term. Families often express anxiety that their loved ones’ quality of life will suffer by going into a residential facility.

We also remain concerned that there is insufficient competitive pressure in aged care at the moment to drive quality to higher levels that will meet growing consumer and community expectations.

In this submission COTA argues that we need greater transparency in the aged care sector, more efficient, effective regulatory processes to identify and respond to episodes of poor quality care sooner, and the improvement or development of systems that promote the protection of consumers’ rights. Greater transparency is particularly important for those living in rural and remote areas where there are fewer service options, or for people with special needs. It also offers the opportunity for more input in respect of their care from residents, their family or friends and other representatives, such as health professionals. Similarly, systems that improve protections for consumers will also encourage them to have a greater say and more choice in care.

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