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Senior counsel assisting Peter Rozen. Photo: supplied

Royal commission lawyers spell out 124 recommendations for commissioners

Australia’s aged care system is littered with systemic failures, rife with abuse and needs to put people first, a royal commission has heard.

Counsel assisting Peter Rozen put forward 124 recommendations for commissioners to consider during the second-last day of hearings on Thursday.

He said there has been an absence of leadership by successive governments in aged care.

“Even though the aged care system caters for more than 1.2 million older people, governments have treated it as a lower-order priority,” Rozen said.

Recommendations suggested include a new planning regime based on demand-driven access to care rather than a rationed approach, as well as an independent process for setting quality standards.

A new enforceable duty of care, mandated staffing ratios in residential care, compulsory registration of personal care workers and an independent pricing authority to determine costs should also be implemented, Rozen said.

He said new aged care legislation based on human rights principles should be brought in to override existing laws.

Final submissions will be heard today and Friday, with the commission set to deliver its final report and recommendations in late February.

Wrapping up 97 days of hearings, Rozen said it was evident the level of substandard care is “far too high” and abuse “remains rife”.

Almost half of the 10,000-plus public submissions received during the two-year inquiry were marked with references to substandard care, he said.

He said 588 mentioned sexual assault, and the number of allegations reported to the federal health department rose from 426 in 2014-15 to 790 in 2018-19.

“It is more than two reports per day of sexual assault on average, every day of the year,” Rozen said.

He said the rate of alleged sexual assaults per 100 residents nearly doubled over that period.

“We submit that the weight of the evidence before the commission supports a finding that high-quality aged care is not being delivered on a systemic level in our system,” Rozen said.

“The level of substandard care is unacceptable by any measure.

“At least one in five people receiving residential aged care have received substandard care.”

Rozen said a “number of systemic failures” included a lack of skilled staff, poor planning, poor governance and leadership from providers and a lack of transparency generally in the sector.

“First and most importantly the aged care system needs to put people first. The preferences and needs of older people really should drive aged care,” Commissioner Lynelle Briggs said.

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One comment

  1. I have worked in Aged Care for 15 years and commenced work in Disability. As an ageing Australian of 49 years and dual qualified, I would like to see mandatory reporting of restrictive practices brought into aged care.

    As a manager of Disability, the use of restrictive practices is a mandatory reporting incidents. I would feel rest assured knowing that if anyone used any type of restraint on me, that it will be reported and overseen. It would give me peace of mind to know that if I go into aged care or my mother goes into aged care, she will not be sedated unnecessarily or left in my room, sat in an over-table chair at the dining table or left in my room for hours on end. Instead a specialist behavior consultant would be asked to assess me, and teaching of staff would occur about how to manage the difficult situation.

    I understand how busy staff are. Ratios really need to be brought in, to help manage the workload and thus lead to better aged care. Experienced managers make a big difference to corporate memory and local solutions to problems with quick resolve. These cannot take place when there are only two AINS for 30 beds and one RN for 60. No one can see what is happening on the other side of the building with single rooms everywhere.

    I would like to see reportable incidents for restraints brought in, but to be able to ensure safe high quality care, the staffing issues need to be addressed. The workload of reporting is time consuming, impacts on an already hectic workload, and takes more care hours away from those who need it most, consumers and staff.

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