Stakeholders say a new review must tackle shortcomings in aged care accreditation that allow poor operators to effectively game the system.
The Commonwealth on Monday announced a review to determine how federal regulators failed to detect the scale of the issues at South Australia’s Oakden facility.
The State Government is closing the facility after the state’s Chief Psychiatrist Dr Aaron Groves delivered a damning review into Oakden, which he said was “like a mental institution from the middle of last century.”
Yet the Federal Government on Monday acknowledged that the federal Department of Health had received complaints about the facility, and both it and the Aged Care Quality Agency had been “working with” the facility’s operators.
“This review will, therefore, consider how the extent of the issues had not become clearer to us,” Minister for Aged Care Ken Wyatt said.
Critics of aged care accreditation have persistently warned the scheme is too focused on demonstrating compliance through paperwork rather than evaluating actual care outcomes. They point to other high profile cases of poor care or neglect at facilities that had passed their accreditation.
Dr Groves said his review heard and saw evidence that the facility “learned how to produce documents and records that accrediting bodies and surveyors wanted to and expected to see… However, it became no better at providing safe or better quality care.”
Similarly, the Productivity Commission’s major review into aged care in 2011 found aged care’s quality framework “is not focused enough on outcomes for care recipients.”
Poor behaviour ‘hidden’
Council on the Ageing Australia said that accreditation had undoubtedly improved quality across aged care but there were still serious issues with the scheme.
“Despite the formal accreditation and complaint processes mandated by successive governments, some poor behaviour has continued to fly below the radar, hidden from the accreditation processes,” said the group’s chief executive Ian Yates.
Many of the residents and families who are affected were often not confident enough to complain, he said.
Alzheimer’s Australia said the review was a “matter of urgency.”
The group’s CEO Maree McCabe said that the vast majority of providers met accreditation requirements yet her organisation continues to receive reports from families of poor care, abuse and inappropriate use of restraint.
“We must question if the current standards set the bar high enough,” said Ms McCabe.
COTA called for the review to “consider systemic solutions to systemic problems” and not just evaluate current practice.
“Residents and their families should have the right to move their bed licence to another nursing home at any time, without any barriers,” said Mr Yates.
Details of review
Included in the review’s terms of reference is an examination of why the Commonwealth’s regulatory processes did not adequately identify the failures at the centre prior to 17 March when sanctions were imposed, and what improvements are needed.
It is unclear whether the review will take submissions or hold hearings.
The reviewers, who are to be announced “in coming days”, will have just four months to produce their report for government.
Labor called for the review to be “genuinely independent and open to receive submissions from anyone with an interest in aged care services.”
Veteran aged care researcher Maree Bernoth said it was incumbent on the review to hear from residents and their family members, researchers and clinicians.
“Strategies need to be made available to facilitate input by these groups. Residents and families may be reticent to write a submission as it seems a daunting task. Instead, they should be able to relate their experiences by phone, Skype or whatever medium they feel comfortable with, and in anonymity,” Associate Professor Bernoth told AAA.
Provider peaks Aged & Community Services Australia, Leading Age Services Australia and Catholic Health Australia all said they welcomed the review.
The new review into accreditation comes as the government moves to implement a streamlined quality framework for aged care and amidst the voluntary roll out of quality indicators.
Correction: An earlier version of this article incorrectly stated that the review’s terms of reference had not been released.
Related AAA coverage: Review into aged care accreditation after failure on Oakden
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