Aged Care in Australia: the way forward

The Royal Commission

Following a series of incidents and media reports about poor quality care for older Australians within aged care facilities, the Royal Commission into the Quality and Safety in Aged Care (Royal Commission) was established.

The Royal Commission was tasked with exploring:

the quality of aged care services

whether aged care services currently meet the needs of older Australians

the extent of substandard care across the system

how the system can be strengthened to ensure aged care services are delivered in a person-centred and sustainable way into the future.

A raft of serious failings

The Interim Report of the Royal Commission¹, titled Neglect, outlined a raft of serious failings of the aged care system including:

difficulties in navigating the aged care system including access, care and supports

a lack of coordination in care and services provided to older people

challenges in accessing care, including long wait times for older people to access home care

poor quality of care across all aged care programs

inappropriate and excessive use of chemical and physical restraints

poor regulatory oversight of providers with poorly articulated standards of care

significant challenges with workforce including shortages and inadequate skills to deliver quality care

lack of access and integration with health services across primary and acute care.

Footnote:

1. Royal Commission into Aged Care Quality and Safety. Interim Report: Neglect, October 2019.
Available at: https://agedcare.royalcommission.gov.au/sites/default/files/2020-02/interim-report-volume-1.pdf. Accessed December 2020

Better outcomes for older Australians

A roadmap of activity to drive better outcomes for older Australians.

Throughout the Royal Commission, we have heard substantial direct evidence about what can happen to older people as they attempt to access aged care, receive support at home and/or once they move into residential care. The case studies have given us invaluable insights into the vulnerability and isolation of older people in all three circumstances. The Final Report states that the issues within aged care are systemic, and include inadequate funding to deliver quality care, inconsistent provider governance, performance and conduct, a lack of system leadership and governance, and poor access to health care.

With the arrival of the Final Report, we finally have the long-awaited recommendations.

The Final Report outlines a roadmap which, if followed, has the potential to lead to better outcomes for older Australians. The sector will need to collectively and individually respond to the recommendations. However, simply considering and responding to the recommendations isn’t enough, there is more that needs to be done.

The recommendations form the critical base for the sector to move forward, but the sector needs to move beyond the recommendations in order to support the development of a high quality and safe aged care system. Providers will need to transform and innovate to ensure that new ideas are continually developed and embedded into practice to continue to raise the standards of quality and safety across the aged care sector.

Where does the sector go to from here?

There are critical recommendations within the Final Report for the sector, including Government, the Commonwealth Department of Health, the Aged Care Safety and Quality Commission, aged care providers and organisations that support aged care, to consider and enact.

To make the changes required to improve outcomes for older Australians, change needs to start today with all players in aged care required to consider their role. KPMG has identified several areas where action can start immediately, including:

These topics will be explored within KPMG’s series on the Final Report from the Royal Commission. There are also other key considerations for the sector, which will support implementing the recommendations, restoring public trust in aged care whilst also supporting to build a sustainable, safe and innovative aged care sector.

Innovation for safety and quality

Whilst not specifically addressed within the Royal Commission Final Report, the sector needs to continue to strive to innovate.

Without innovation, the risk is that the step change that needs to occur within the aged care sector to deliver quality outcomes for older Australians, will be a single step change without the flexibly to adapt for changing needs in the future. Innovation has been a challenge for a significant amount of time within the sector.

There have been a small number of providers that have developed a culture for innovation and embedded it within their organisation, from their leaders through to their service model and the health professionals and care workers that deliver the care. It is vital that the barriers to innovation within the sector, which are outlined in KPMG Australia’s 2019 report, ‘Innovation in age services – Overcoming barriers’, are explored as much as the individual recommendations within the Final Report.

Innovation in age services – Overcoming barriers

Innovation in Aged Care Services

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Innovation is not just about technology or financial investment, it is about adopting a growth mind set and being open to exploring new ideas and opportunities to enable your people to truly improve how things are done.

James Mabbott

Partner KPMG Innovation, Solutions and Ventures

Rebuilding trust

Between the Royal Commission and the COVID-19 pandemic, public trust in the aged care sector has eroded significantly.

This needs to be addressed by all parties within the aged care sector and is critical to the future of the sector. Without restoration of public trust, the implementation of recommendations from the Royal Commission will not be able to reach the older Australians who need care the most.

This is a critical issue that needs to be addressed in order to restore providers’ and government’s social license to operate in aged care. This means going beyond regulatory compliance, as well as being able to identify and address reputational risks.

As part of this process, engagement with older Australians and the broader community is key.

Lastly, building on the need for public trust, is the need for our society to embrace older Australians. We need to place greater value on the contribution of older Australians, be open to discussions about ageing and what that means and celebrate the considerable impact they have made on our society today.

In fact, we need to consider how we better learn from our ageing population as the knowledge they possess is great. Without this, it will be very difficult to enact real change in the sector.

All Australians, not just the key players in the sector need to be committed to, and enable the changes that need to occur, with the most important change being to value each and every older Australian.

We look forward to sharing our insights on the practical and necessary steps the sector can take to demonstrate their positive and proactive response to the Recommendations.

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