Home | Industry+Policy | Advocate calls for new approach to random inspections in aged care

Advocate calls for new approach to random inspections in aged care

A new not-for-profit organisation is calling for the government to allow community-based retired health professionals, social workers and advocates to undertake random inspections of aged care facilities to curb elder abuse.

Greysafe, which was set up early this year and aims to prevent the abuse, neglect and exploitation of older Australians, will write to the Minister for Aged Care Ken Wyatt urging him to hire an independent team of ‘Grey Guardians’ across Australia.

Chief executive and founder Michael Riley said the new scheme would improve the transparency around the reporting process. “The Australian Aged Care Quality Agency (AACQA) can continue to do the accreditation process, but this inspection scheme that we’re proposing would allow a bit more confidence from the community that there are more inspections taking place, and that they’re happening independently of any agency that’s doing the accreditation process,” Riley said.

Under the scheme:

  • The federal government would set a minimum quota for the number of inspections needing to take place across all parts of Australia.
  • The government would call for expressions of interest from retired doctors, nurses, social workers and trained professional advocates to form locally based teams of Grey Guardians who would undertake random inspections to both assess and report on the care and condition of aged care residents and the facilities themselves.
  • The Grey Guardians would report into an independent office separate from the AACQA.
  • Guardians would be locally based in and around their communities, be retired or semi-retired and not currently employed as an aged care assessor with AACQA.
  • They would be paid a small stipend to cover costs and would be available to conduct inspections, if required, out of office hours and on weekends.
  • Interviews with residents, their families and nursing staff would become the first priority for random inspection visits.

Greysafe is also calling on the government to take out advertising space in major newspapers and publish a report card for the previous three months of the number of assaults in aged care and the details of aged care facilities that have failed to meet 100 per cent compliance with accreditation and random inspection checks.

In the quarterly report card, the government would also publish the numbers of random inspections conducted, the names of the facilities inspected and the findings.

Riley said: “At the moment, because there’s a bit of a crisis of confidence in the community about the whole accreditation and inspection scheme and care of residents, we need a bit more transparency in the system, so this goes some way towards repairing the community’s trust in the aged care system in Australia.”

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8 comments

  1. Just another attack on the residential aged care industry rather than actually understanding the problem of elder abuse.
    Most instances of elder abuse actually occur in the community from a mix of professional carers, family members, friends and individuals from the wider community.
    RACFs are already under high scrutiny through the current accreditation process including random inspections. There is also mandatory education attended in these facilities and in many instances the staff at these facilities are under supervision from other staff members due to the nature of team nursing.
    It is behind the closed doors of the private home where individuals are most at risk for abuse and there are certainly no inspections occurring in these situations, often even when concerns are raised with authorities.
    In addition, what benefit will be achieved by retired professionals entering facilities after hours in this proposed scheme? If the individual is retired they most likely will not be maintaining their registration and are therefore no better a choice than a random individual off the street. To say that their previous background qualifies them to make inspections does not take into account what area of healthcare they may have previously worked in, how long ago it was and whether they were actually any good in their position.
    Furthermore, these ‘strangers’ entering the facility are actually then a risk of being someone who may commit an act of elder abuse. Therefore, do staff now have to take time off the floor to accompany them around the facility. Also what limitations will be placed on entering the facility after hours. Can they arrive at 10pm requesting to interview residents and staff?? What a risk to the security of the facility and the comfort of residents who will become upset and concerned by this type of action.
    Also, if these individuals are being sourced from the surrounding community, there is always a risk that the individual could hold a grudge against a particular facility due to previous experiences with the admission of loved ones or even in the event that they just do not like the facility based on unfounded notions. What checks will be attended to determine if this is a risk? Will there be a process for these individuals to declare if they have any past history with the facility?
    In regards to the Government posting full page aids in the newspaper, how ridiculous! This money should actually be spent on aged care funding which is repeatedly being stripped back. This information regarding accreditation reviews and outcomes is already available on the agency website and available to any individual who wants to view it. To spend money on newspaper ads which only a portion of the community would access (note the decline in newspaper sales in recent years) is wasting money for absolutely no reason.
    In relation to wasting money, this whole scheme involving setting up another department for these people to report to, the money paid to them to cover expenses, the criminal checks that will need to be attended on these individuals, the education they will need to receive for the role, and the publication of a report card is all money that should be allocated to the industry instead of squandered in such a manner.
    To make the statement that there is a “crisis of confidence” and that we need to be “repairing the community’s trust” is an example of an out of touch CEO who is likely using the status of the not for profit entity to push his own agenda. There is no crisis of confidence! And the only trust that has been lost is in the Government who is pulling the funding from the most vulnerable people in our community while the Opposition, Unions, Advocacy Groups, Media etc look on from the side lines.
    If you want to help maintain the safety of individuals in RACFs, then lobby the Government to restore the funding, increase pay for aged care staff particularly RNs, mandate that 24/7 RNs are required and introduce compulsory safe working ratios.

    • You do make some valid points, but the whole tone of your response to the article is defensive and occasionally alarmist. Yes, there’s an absolute need for pay increases for staff in RACFs but that is determined by workplace agreements between providers and their employees. Wages under relevant State or Commonwealth Awards only provide a safety net for employees. If a provider increases wages, what productivity increases will offset them? That’s the dilemma facing managers in those facilities.

      To say ‘ Furthermore, these ‘strangers’ entering the facility are actually then a risk of being someone who may commit an act of elder abuse’, implies that elder abuse is more likely to be perpetuated by someone who is not close to the resident. Is that really true? As you attest elsewhere in your article, elder abuse is often perpetuated by relatives or ‘significant others’ outside a RACF. How would you suggest that be addressed? I work in Home & Community Care & if I suspect that my client is at risk in any way I report it to my employer. I have worked in RACFs and while I did not witness elder abuse, I did see situations where staff were so overworked they did not have time to provide the emotional support residents needed. Those supportive relationships are just as important as providing the medical and physical care residents require.

      I’d hazard a guess that you are a RN in a RACF? Both ENs and RNs are certainly under pressure in that environment, just as they are in hospitals.

      Rather than worry about someone judging you or your peers in a RACF perhaps you could channel your energies into being an active voice in your current workplace to ensure residents are receiving the care that you would want your parents to receive.

      • Biffityboo,

        Please see my response to Glenda. While I do have an RN background, I am not an RN in a RACF and am in fact a family member of a resident in RAC. Therefore, I am not at all worried about someone judging myself or my peers in a RACF.

        I am however an active voice, hence my response to this article. I am campaigning for better care for our elderly both at home and in RAC in this country.

        To determine that my response is defensive is likely more to do with the fact that you thought I was an RN in a RACF. I can also read your response in a defensive tone. I would be interested to hear which points you thought were also alarmist? However, I do think we should be alarmed. This type of proposal is typical of the approach taken toward RAC in the media, Government and through groups such as the not for profit in the article. They are not looking at the right things and are instead wasting time and resources.

        In regards to staff pay, there is evidence in the industry of employers reducing wages, freezing wage increases and refusing to convert staff from casual to permanent positons due to the rolling funding cuts from the Government. Hence, my point that the Government needs to be lobbied on this issue. In addition, for the type of work that staff in RAC do, the award wages should be set higher so that the Industry has a minimum wage consistent with the type of work we are expecting of these individuals. As the old saying goes, if you pay peanuts, you get monkeys.

        My statement regarding ‘strangers’ entering the facility, in no way implies that elder abuse is more likely to be from some one who is not close to the resident. I don’t understand how you have made this connection. It is merely pointing out that, in this proposal, which is supposed to be helping to stop elder abuse, you are introducing another element of the community who could in theory commit an abusive act. This then leads into my comment questing how this is to be managed, particularly if these people are visiting after hours and are under less supervision themselves.

  2. Anne

    Whatever the merits of this proposal, the gentleman makes some points i do agree with. RAC is in crisis whether from poor trained staff, insufficient quality staff and there are patients being mistreated or not adequately cared for. As a night shift aged care nurse, I’ve never seen a random inspection in 15 years of nursing at the facility I’m at. The accreditation system is a joke and to suggest it is anything is naive. I watched that 7.30 report last week and said to other staff, that could easily be here. The govt has three or so reviews going on into accreditation right now so something isn’t right.

    As long as they are trained, I’d rather have local medical professionals or advocates keeping our management and some of our low trained staff in check, than what happens now – which is zilch.

    I also think it is a a bit of a cop out to suggest that because more elder abuse happens at home, we can all pat ourselves on the back in RAC and say we are less worse than home carers is to have your head in the sand.

    Yes, more nurses are needed, but properly trained nurses and there needs to be more checks and balances on RAC facilities beyond a paper trail check because until we have a clean slate, until nobody is abused or passing from other than natural causes, we have a major problem. To say any different, in the face of whatever reports keep popping up in the media, is to shoot the messenger rather than address the underlying problem.

    • Judy,

      I am not ‘shooting the messenger’, I am arguing against the proposal that has been outlined in the article and have backed up that argument with my reasoning.

      In addition, you talk about addressing the underlying problem but this is one of my points. This proposal does not address the ‘underlying problem’ and is instead another ‘band aid’ solution and exactly why I have a major problem with it.

      At no point did I say “we can all pat ourselves on the back in RAC and say we are less worse than home carers”. I did note that most instances of elder abuse occur in the community and noted the checks that are already in place for RACFs which is in contrast to the lack of scrutiny on people being cared for at home. I happen to take an interest in all of our elderly, not just those residing in RACFs.

      More checks and balances are not a bad thing for RACFs, however this proposal is flawed and will only add to an already flawed system.

  3. Anne Cox has summed up the outrage I feel at this suggestion.
    A better idea would be to put these resources in the hands of people like the public guardians which in theory have an obligation to investigate allegations of elder abuse but in practice do not have the resources to do so. Rather than creating a new system that won’t work Grey Guardians could add resources to an existing system and make it work better.

  4. Glenda McConville

    Anne

    What I find more disappointing is the defensive response from someone who either must work in management or government. As the relative of a resident of one of the five or six facilities that has been in the media recently for having poor quality care, how can you claim we have an accreditation system that works well?

    This I find is typical of the response I got when I raised care and cleanliness issues at the ‘accredited’ facility. Defensive, close enough is good enough etc etc. How ironic it is now on the black list. I have some news for you Anne, there is a crisis of confidence in the community. I for one would really like to see the government publish a report in the newspaper about the good and the bad facilities. Hold them to account.

    Maybe if we didn’t have such a woeful and inadequate accreditation scheme, more people at the community level with some interest in checking up on the lack of care and compassion at many RAC facilities and less pass the buck from management and politicians, I wouldn’t have to wake up each day hoping my elderly relative is not going to join the growing list of the abused or assaulted.

    I say bring on more checks and more media reporting of the bad apples!

    • Glenda,

      For your information, I do not work in management or government. While I do have a background as a Registered Nurse, I am in fact speaking from the perspective of a relative.

      To read this as a ‘defensive response’ is only due to your own view of aged care and the negative issues and experiences you have faced. I can certainly interpret your response in many ways also.

      I am merely pointing out (and yes, venting my frustration) that this notion of Grey Guardians will not actually achieve the purpose of keeping people safe, will cost an excessive amount of money that can be better used elsewhere and could in fact lead to further risk to residents.

      In addition, I did not “claim we have an accreditation system that works well”. I did note what is already in place via the current system but at no time did I state the system is working well. However, you don’t take a flawed system and add an additional component such as Grey Guardians and expect that this will solve issues. It still leaves a flawed system but now with more red tape.

      As I noted, if you want to help maintain safety in RACFs and improve standards of care then the Government needs to be pressured to act on issues such as funding (which they are cutting rapidly) and staffing ratios.

      If you are also unhappy with the current system of accreditation, then lobby the Government on this issue also but it needs to include a full review of the system not just tacking on some half baked idea in a ‘fill the gaps’ approach.