The Final Report

The final report from the Royal Commission into Aged Care Quality and Safety (Final Report) was tabled on 1 March 2021, and contains significant and sweeping proposals for reform of the aged care sector. This is the second of a series of articles by Kinny Legal examining what these proposed reforms are and how they might change the industry if implemented.

This article

While the Final Report expresses a wide range of concerns about aged care quality and safety, it has identified four areas of concern which the Commissioners have determined require immediate attention:

1. Food and nutrition.

2. Dementia care.

3. Use of restrictive practices.

4. Palliative care.

This article considers the Commissioners’ findings about dementia care and what this might mean for your aged care organisation. The findings are most relevant to residential aged care organisations in the short term, but are relevant to all providers in the medium to long term.

What the Final Report says

The Final Report has revealed that the substandard quality of dementia care was a persistent theme of the inquiry. In particular, the Commissioners stated that the quality of aged care support people living with dementia receive is, “at times, abysmal.”

A clear concern highlighted by the Final Report is that, despite estimates that more than half of all nursing home residents have been diagnosed with dementia, dementia care is not being treated as a core business and staff members do not have the time, skills or capacity required to adequately deliver the care needed for people living with dementia.

The Commissioners also observed that while its comments were predominantly directed towards residential aged care providers, dementia care would over time become more important in home care.

What the Final Report recommends

The Final Report makes a general recommendation that all mainstream aged care providers should have the capacity to deliver high quality aged care for people living with dementia, including by having:

1. The right number and mix of staff members who are appropriately trained in dementia care.

2. The right physical environment (in residential aged care facilities), to better accommodate the needs of residents living with dementia and promote a better quality of life.

3. The right model of care.

More specific recommendations in relation to each of the above three broad recommendations include the following:

1. All staff members in direct contact with persons living with dementia while performing their work duties receive mandatory regular training in dementia care, and that this training requirement be a condition of approval for approved providers.

2. Dementia-friendly design should be the norm for all new or substantially refurbished residential aged care buildings.

3. The Australian Government develop and publish a comprehensive set of voluntary National Aged Care Design Principles and Guidelines on accessible and dementia-friendly design for residential aged care.

4. Small household models of care are more likely to be dementia-friendly than larger institutional settings.

5. The Australian Government should financially incentivise approved providers who adopt the Design Principles and Guidelines and develop dementia-friendly residential aged care accommodation such as the small household models of care.

How to respond

The Final Report will almost certainly prompt broad regulatory changes in the aged care sector. This issue was identified as requiring immediate action, so changes could be imminent. Residential aged care providers should make sure they are ready to respond. Appropriate steps to take include:

1. Assessing all policies, procedures, systems, and the quality of training currently in place for dementia care.

2. Determine the extent to which they are being implemented in practice.

3. Assessing the built environment of your organisation’s residential aged care facilities, including what changes could be made to better accommodate persons living with dementia (now or in the future as their care needs change).

4. If your organisation has tabled acquisitions, development or refurbishment activities – whether to amend these strategies having regard for the above matters.

5. Monitoring for announcements of any financial incentives that could be relevant to your new strategy – e.g. for new builds or refurbishment of existing buildings.

6. Assessing what (if any) changes would need to be made in your organisation if the above recommendations were implemented tomorrow.

7. Determining what external help (if any) you would need to make those changes.  For example – lawyers, recruiters, training and course providers.

8. Assessing how confident you can be in each of your above assessments.  For example – how confident are you in the quality and comprehensiveness of the data you have used to make those assessments, and how often is this data being used as part of a continuous improvement strategy?

Need help?

We are repeatedly ranked as one of Australia’s top law firms in aged care, and regularly advise clients in relation to aged care compliance issues. If you need help addressing this issue or any other aged care compliance matter, please do not hesitate to call us on 02 9199 4563.

 This blog post does not constitute legal advice and should not be relied upon as such. It is a general commentary on matters that may be of interest to you.  Formal legal or other professional advice should be sought before acting or relying on any matter arising from this communication.