Response 625165606

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Introduction

2. Are you answering on behalf of an organisation? If so, please provide your organisation's name.

Please select one item
Yes
Ticked No

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

Please select one item
(Required)
Ticked Yes
No

More detail about you

4. What role best describes you? Please select all that apply.

Please select all that apply
Aged care consumer, including family and/or carer
Ticked Aged care service provider
Aged care worker/professional
Aged care advocate
Peak body - consumer
Peak body - provider
Peak body - professional
Other - please specify below

5. Do you identify with any special needs groups, or, does your organisation provide support or services to any special needs groups? Please select all that apply.

Please select all that apply
People from Aboriginal and/or Torres Strait Islander communities
People from culturally and linguistically diverse (CALD) backgrounds
People who live in rural or remote areas
Ticked People who are financially or socially disadvantaged
People who are veterans of the Australian Defence Force or an allied defence force including the spouse, widow or widower of a veteran
Ticked People who are homeless, or at risk of becoming homeless
People who are care leavers (which includes Forgotten Australians, Former Child Migrants and Stolen Generations)
Parents separated from their children by forced adoption or removal
People from lesbian, gay, bisexual, trans/transgender and intersex (LGBTI) communities.

6. Where do you live, or, where does your organisation operate? Please select all that apply.

Please select all that apply
Ticked NSW
VIC
QLD
WA
SA
TAS
ACT
NT

7. What is your location, or, the location where your organisation operates. Please select all that apply.

Please select all that apply
Ticked Metropolitan
Regional
Rural/Remote

8. If you are an aged care service provider, please select all the types of care your service delivers.

Please select all that apply
Ticked Residential care
Home care
Commonwealth Home Support Programme services
Transition care
National Aboriginal and Torres Strait Islander Program services
Multi-purpose services
Innovative care services
Short term restorative care services

9. If you are an aged care service provider, which option below best describes the size of your organisation?

Please select one item
Ticked Small
Medium
Large
Very large

General questions about the draft standards

10. Do the consumer outcomes in the draft standards reflect the matters that are most important to consumers?

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

11. Are the organisation statements and requirements in the draft standards achievable for providers?

Please select one item
Yes, always
Yes, mostly
Ticked Yes, sometimes
No
Don't know
Suggestions - are organisational statements and requirements achievable
Whilst it is admirable that the Government is taking a consumer centred approach, offering too much choice has the potential to significantly increase the cost of care provision, as well as introducing confusion and anxiety for consumers. The "Paradox of Choice - Why More Is Less" is a 2004 book by American psychologist Barry Schwartz. Schwartz found that autonomy and freedom of choice are critical to our well being, and that choice is critical to freedom and autonomy. Nonetheless, he found that although modern Americans have more choice than any group of people ever has before, and thus, presumably, more freedom and autonomy, the American people don't seem to be benefiting from it psychologically. Schwartz assembles his argument from a variety of fields of modern psychology that study how happiness is affected by success or failure of goal achievement. Schwartz discusses the significance of common research methods that utilize a Happiness Scale. He sides with the opinion of psychologists David Myers and Robert Lane, who independently conclude that the current abundance of choice often leads to depression and feelings of loneliness. Schwartz draws particular attention to Lane's assertion that Americans are paying for increased affluence and freedom with a substantial decrease in the quality and quantity of community. What was once given by family, neighbourhood and the workplace now must be achieved and actively cultivated on an individual basis. The social fabric is no longer a birth-right but has become a series of deliberated and demanding choices. Schwartz also discusses happiness with specific products. For example, he cites a study by Sheena Iyengar of Columbia University and Mark Lepper of Stanford University who found that when participants were faced with a smaller rather than larger array of jam, they were actually more satisfied with their tasting. Schwartz also finds that when people are faced with having to choose one option out of many desirable choices, they will begin to consider hypothetical trade-offs. Their options are evaluated in terms of missed opportunities instead of the opportunity's potential. Schwartz maintains that one of the downsides of making trade-offs is it alters how we feel about the decisions we face; afterwards, it affects the level of satisfaction we experience from our decision. While psychologists have known for years about the harmful effects of negative emotion on decision making, Schwartz points to recent evidence showing how positive emotion has the opposite effect: in general, subjects are inclined to consider more possibilities when they are feeling happy.

12. Are the draft standards measurable?

Please select one item
Ticked Yes, always
Yes, mostly
Yes, sometimes
No
Don't know
Text box - suggestions are draft standards measurable
Yes, however how then does the Government propose to prioritise one consumer's choice over another's? The standards do not reflect the inevitable reality of compromise; compromise between consumers, and compromise between consumers and care providers. The draft standards rightly acknowledge that "consumers will not always be able to exercise unfettered choice, including where this adversely impacts on others", however that proviso needs to be extended to "including where this can not be viably supplied by care providers, whether as a result of economic or practical considerations".

13. Are there any gaps in the draft standards? If so, what are they?

Please select one item
Yes
Ticked No

14. Is the wording and the intent of the draft standards clear?

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

15. Are any draft standards or requirements NOT relevant to the following services? If so, please provide details below.

Text box reason why stanard is not relevant
N/A

Specific suggestions about each draft standard

16. Do you have any specific suggestions in relation to draft Standard 1: Consumer dignity, autonomy and choice? If so, what are they?

Text box Standard 1 Consumer dignity, autonomy and choice
Standard 1.6 needs to be re-worded to take into consideration a consumer's right to choose what they personally consider to be private or confidential. For example, a consumer may be seated in a common or public area, whereby they openly initiate and engage in a conversation or receive care provision that others may consider ought to be held in private or conducted in a confidential manner. The ability for a consumer to make such a choice is inline with the provisions of standard 1.3(b) and 3.1. Furthermore, the consumer has the right to choose this action if by doing so it does not adversely affect other consumers, visitors, contractors, or the workforce of the facility.

17. Do you have any specific suggestions in relation to draft Standard 2: Ongoing assessment and planning with consumers? If so, what are they?

Text box suggestions in relation to draft Standard 2: Ongoing assessment and planning with consumers
Standard 2.1 makes the erroneous assumption that the consumer's "family and carer" are (or will be) agreeable with each other in the "assessment and planning of their (elder's) care and services". For many, the chances of a civil family meeting whereby they identify and decide upon a plan of care for the needs of their elder, as well as agree upon who does what, are minimal. You will see primary caregivers stressing over siblings accusing them of spending too much of their parents money to care for their parents. You will read the pleas for help from the one sibling who has quit his or her job to care full time for an ailing parent being either ignored by siblings, or worse, being accused of predatory intentions because they are "running the show". You will witness siblings who are not on speaking terms with each other making decisions in spite of their siblings wishes, simply because the other sibling has made a particular request, not because they especially feel it is in the consumer's best interest. The standards need to accommodate for this reality, and to allow care providers the right to request that a consumer (or their representative) nominate a singular point of contact within the family that the care provider with liaise with for care assessment and planning purposes.

19. Do you have any specific suggestions in relation to draft Standard 4: Delivering lifestyle services and supports? If so, what are they?

Text box suggestions in relation to draft Standard 4: Delivering lifestyle services and supports
As worded, this standard creates a liability for care providers to provide active assistance in the capacity as a consumer's social worker, personal concierge, or assistant. More poignantly, the standard ought to be reworded to instead state that care providers will not hinder a consumer's desire to participate in the community, select and maintain social and personal friendships, or do the things that interest them, or at the most assist insofar as they are viably able taking into account economic and practical considerations. To provide an example, a technologically inept consumer may wish to access social media due to loneliness. The wording of this standard would place responsibility on the care provider to facilitate the consumer's request to access a social media account, and to support them in maintaining an active online presence for the purposes of interacting with others in accordance with their desires. Such a personal lifestyle decision really ought not to be the responsibility of care providers, unless under the auspices of an "extra service".

20. Do you have any specific suggestions in relation to draft Standard 5: Service environment? If so, what are they?

Text box - specific suggestions in relation to draft Standard 5: Service environment
In standard 5.1 how is the Government proposing to assess, in a communal living environment, that all consumer's experience "comfortable internal temperatures, ventilation, and noise levels"? Who determines what is "comfortable", and what measure will be applied to these parameters? If one consumer wants the common (public) area fans on, and another wants them off, against which consumer's choice will the standard be applied? Who determines what constitutes "suitable" furniture and equipment, and how will this be qualified? Standard 5.3 needs to clarify that some areas of the service are not publicly accessible areas (e.g. commercial kitchen, commercial laundry, loading dock, staff rest areas, office administration areas, etc.) Standard 5.4 needs to clarify that the consumer is responsible for returning their environment to the state it was prior to their occupancy, subject to fair "wear and tear".