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 fourth 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 palliative care and what this might mean for your aged care organisation. The findings relevant to all aged care organisations which provide palliative and end of life care.

What the Final Report says

The Final Report identified palliative care as a common area of substandard care which was the subject of the inquiry.

The Final Report states that palliative care should be considered a core business to residential aged care providers, as many residents will spend their final chapter of life in an aged care facility, yet the inquiry revealed several cases where care was “severely lacking and fell well short of community expectations” (page 6, Volume 1 of the Final Report) and that staff tended to be under-skilled and under-educated in palliative care.

What the Final Report recommends

The Final Report recommends several reforms to ensure:

• high quality palliative care becomes a core business of residential aged care providers;

• aged care workers undergo regular palliative care training, with urgent action to ensure current direct care staff are upskilled;

• seniors have improved access to specialist palliative care services; and

• seniors have a right to fair, equitable and non-discriminatory access to palliative and end-of-life care.

More specifically, the Final Report recommendations include the following.

• By 1 July 2021, the Australian Government should establish a scheme to reimburse aged care providers for the cost of providing palliative care education and training to certain direct care employees (amongst other education and training programs).  The Final Report recommends that these reimbursements extend to the costs of additional staffing hours incurred by providers to enable an existing employee to attend the eligible education or training.

• By 15 July 2021, the Minister should refer the Australian Commission on Safety and Quality in Health and Aged Care to urgently review, and if necessary update, the Aged Care Quality Standard to ensure they operate in a way that achieves high quality palliative care in residential aged care, and the Commission should complete its review by 31 December 2022.

• By 1 July 2022, the Australian Government should implement as a condition of approval of aged care providers, that all workers engaged by providers who are involved in direct contact with people seeking or receiving services in the aged care system undertake regular training about dementia care and palliative care.

• By 1 July 2024, the Aged Care Act should be amended such that home care services providing high-level services such as palliative and end-of-life care services must be accredited in order to receive Australian Government subsidies.  

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. Aged care providers should make sure they are ready to respond. Appropriate steps to take include:

1.  Assessing all policies, procedures, systems, and scheduled training and education currently in place for palliative care.

2. Determining the extent to which the above are being implemented in practice.

3. Ensuring that all residents receiving palliative care are cared for so that their pain is minimised, their dignity maintained, and their wishes respected.

4. Assessing the organisation’s processes for communicating to and supporting families of recipients of palliative care.

5. Monitoring for Australian Government funding announcements, and identifying which direct care employees ought to be referred for additional training and education in the event reimbursements are approved.

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.