Response 504850188

Back to Response listing

Introduction

2. Do you give consent for your submission to be published in whole or in part?

Please select one item
(Required)
Ticked Yes
No

Details about you

3. Are you answering on behalf of an organisation?

Please select one item
Yes
Ticked No

4. Where do you live or where is your organisation based?

Please select one item
NSW
Ticked Vic
Qld
WA
SA
Tas
ACT
NT
City/Town
Redacted text

More details about you

8. What role best describes you?

Please select one item
Aged care consumer
Ticked Family and/or carer for an aged care consumer
Aged care worker/professional
Aged care advocate
Clinician/geriatrician
Health worker/professional
Other
If other, please specify
In addition, I am also a registered Nurse with a background in aged care nursing

Questions about accreditation and monitoring compliance of residential aged care services

11. Do you think that processes to accredit and monitor residential aged care services are effective?

Accreditation process
Please select one item
Yes, always Yes, mostly Yes, sometimes Ticked No Don’t know
Monitoring process
Please select one item
Yes, always Yes, mostly Yes, sometimes Ticked No Don’t know

12. Do you think processes to review and investigate non-compliance with the accreditation standards are effective?

Please select one item
Yes, always
Yes, mostly
Yes, sometimes
Ticked No
Don’t know

13. Are you aware that sanctions can be imposed on residential aged care services when they fail to comply with the accreditation standards?

Please select one item
Ticked Yes
No

14. Do you think these sanctions are effective?

Please select one item
Yes, always
Yes, mostly
Ticked Yes, sometimes
No
Don’t know

15. What features of the existing assessment and monitoring process should be retained?

Retain assessment & monitoring processes
The principles of non compliance and the ability to sanction facilities must be retained. Frequently, these systems are the only way of ensuring that Approved Providers will be held accountable for their actions or management of a facility. The complaints scheme should be an independent party and this should be maintained to ensure some degree of transparency and advocacy in the process. As far as mandatory reporting goes, facilities are only obliged to report physical or sexual abuse. There is no obligation to report financial or psychological abuse. This should be considered as many facilities struggle with families that are difficult or refuse to pay for bills/ clothing or items required by the resident. Processes of planned and unplanned visits must continue. Facilities frequently employ additional staff prior to an accreditation process to "clean up" any identified issues but then do not maintain these standards between the accreditation visits.

16. What features of the existing assessment and monitoring process should be changed?

Change assessment & monitoring
The degree of accountability with regard to staffing needs to be strengthened. It is frequently a decision made by an accountant or manager regarding rosters and staffing profiles. Decisions to cut staffing are based entirely on financial reasons and never of care needs or requirements of residents. Facilities must be able to have flexibility in their staffing to deal with complex medical conditions, severe behavioural problems or during the end of life phase. Structure and minimum staffing levels MUST be considered in order to ensure all residents receive a minimum standard of care and this is not based on a financial decision but is needs based. More "unplanned" visits should be considered. Out of hours or weekend visits should be considered.

Questions about complaints

17. Have you made a complaint about a residential aged care service in the last 10 years?

Please select one item
Yes
Ticked No

Never made a complaint

25. Please identify why a complaint has not been made.

Please select all that apply
Ticked No reason to make a complaint
Didn't know how to
Too much effort required
Fear of retribution for making a complaint
No confidence in the handling of a complaint
You are welcome to provide further details on your response
Where I have been dissatisfied with care I have addressed the issue directly with the facility and have had appropriate response from them.

26. Do you have any suggestions for how complaints handled by the Aged Care Complaints Commissioner could be better handled?

Note: this question is included for organisations and those individuals who have not made a complaint
Often families may want to complain about an issue but feel a "specific" incident has to occur. Families may feel that the food offered at the facility is unacceptable but may be asked questions like - is the food to hot or cold? - is there a variety of food on offer? - do residents have an alternative available if required? All of these questions are relevant can be interpreted subjectively. What one person thinks of as an adequate diet might be unacceptable to another. Also there are no minimum care standards evident. How many times a day should my mothers receive mouth/ dental care? Where is the evidence of this care captured? Staff can advise me they attend to the care twice a day but if I find food under her dentures that is hard and crusty, chances are it has been there for more than a day. There is no "bar" to measure against. This makes it difficult for families, residents and even staff to know what is the acceptable standard of care we must be adhering to..

Additional comments

27. Do you have anything else that you would like to contribute to the Review?

Additional comments
One of the biggest issues is around staffing. Until there is action on minimum staffing levels things will not change in this sector. Over the past 10 years there has been a significant increase in the frailty and complexity of care needs of our frail aged population. This is primarily die to the success of the federal governments home care programs. People stay in their homes longer than in past years, so as a result they are frailer, more cognitively declined and complex when they enter a residential care facility. The staffing over the past 10 years has seen a decrease in numbers of staff caring for residents (informal staffing ratios in the aged care sector) and a significant decrease in the number of senior qualified staffing in the sector (look at the decreasing number of RNs and ENs compared to the increasing number of PCAs AINs). In my mothers case her lovely facility has been taken over by a large corporation. Since that time the staffing ratio has changed significantly. The facility has approximately 100 residents and now has two less staff on a morning shift to provide care. Most of these staff have a certificate 3 in aged care. There is one RN on the floor for all the residents and one EN in each wing (two wings). My mother has Alzheimers Disease. She wanders and also demonstrates physical and verbal aggression. She is cared for on a morning shift by one person who cares for her and 7 to 8 other residents. My mother needs full physical assistance with showering, dressing and grooming. She forgets to eat and requires assistance with meals. She is incontinent and requires full assistance with toileting. She is one of nine and one staff member needs to provide care for her and eight other residents, some of whom are more frail and needy thatn she is. It is just a sheer impossibility to provide a level of care and monitor these residents closely due to behavioural/ wandering episodes. In addition, these staff are not skilled to be able to monitor and assess residents state of deterioration. As a result, problems are not identified in the early stages and often it is not until something catastrophic occurs that interventions are made. As a daughter, I feel like I am constantly complaining and these staff are incredibly overworked and undervalues. As I result my father (aged 89 years) and myself try to visit every day to ensure there is someone there for her safety. Our elders deserve better than this. Care should be provided based on need NOT on the organisations financial position. Senior staff are often "trapped" by the computer because evidence for care/ assessments/ care planning is so heavily linked to funding. The ACFI is a funding tool and not an assessment tool, however organisations will happily invest in staff to create funding assessments and documents but conversely don't provide staff to actually manage the residents on the floor. Most of the assessments and care plans in aged care of "figments of someone's imagination". Organisations fraudulently create care plans based on the ACFI funding claim that rarely represent the care the resident is actually receiving. Enough is enough.. These frail elders have been tax payers all their life.. Why is this sub standard care accessible. Lets not even go the gaps between state and federally funded programs such as palliative care for our frail elders... This is an opportunity to create a model of care that will enhance the lives of our frail elders. Please take this responsibility seriously. We are all counting on you to do so.