Reforms proposed by the Australian Law Reform Commission (ALRC) in its elder abuse discussion paper released last week would have a significant impact on aged care providers if enacted.
Eleven of the 43 recommendations made in the paper relate specifically to aged care, and would see increased regulation of the industry and greater power given to the Aged Care Complaints Commissioner and Department of Health over residential care providers.
While ACSA and LASA welcomed the discussion paper, both CEOs cautioned that greater consideration of the recommendations is needed.
In its submission to the inquiry, ACSA pointed to strong evidence that the vast majority of elder abuse occurs in the community.
“The research is clear that most perpetrators of elder abuse are relatives. Both Australian and international studies report that 90 per cent of alleged perpetrators of elder abuse are related to the older person.”
“In residential aged care, the available statistics are largely based on the compulsory reporting requirements introduced in 2007. These require providers to report “allegations and suspicions”, not just proven or substantiated cases. The reports amount to around 1% of residents per year,” the submission stated.
Financial and psychological abuse are recognised in the discussion paper as being the two most common forms of elder abuse.
One of the ALRC’s first recommendations is for a national prevalence study to be commissioned to give a clear picture of the full extent of the problem in Australia.
The proposed reforms relating to aged care include:
– a reportable incidents scheme that would be overseen by the Aged Care Complaints Commissioner from a complaint through to the provider’s investigation of and response
– The removal of an exemption to reporting of alleged or suspected assaults committed by a care recipient with a pre-diagnosed cognitive impairment on another care recipient.
– a national employment screening process for Australian Government funded aged care.
– A national database to record the outcome and status of employment clearances
– Unregistered aged care workers who provide direct care to be subject to the planned National Code of Conduct for Health Care Workers.
– Regulation of the use of restrictive practices in residential aged care unless under specific circumstances
– National guidelines for the community visitors scheme to be developed by the Department of Health (Cth)
– Provisions in the Aged Care Act 1997 for an ‘official visitors’ scheme for residential aged care whose functions would be to inquire into and report on whether the rights of care recipients are being upheld, the adequacy of information provided to care recipients about their rights, including the availability of advocacy services and complaints mechanisms; and concerns relating to abuse and neglect of care recipients.
Luke Westenberg, CEO of the newly formed Aged Care Industry Association, said he is concerned if the Commission’s recommendations were seen to support the view that elder abuse is perpetrated by aged care workers.
“Most people work in aged care because they want to care for older people; when we are bombarded with media stories and commentary suggesting that aged care workers abuse older Australians, I feel we are at risk of demoralising our workers, reducing the attractiveness of aged care for potential workers, causing unnecessary concern for older Australians, and undermining the very real contributions made by aged care workers every day,” he said.
He also noted that funding cuts to residential care have not made it easy for providers to invest in workforce initiatives.
“At some point, quality of care requires sufficient funding; there seems a contradiction at some level between the Government seeing aged care as a target for funding cuts, and suggesting that quality of care is inadequate.”
The proposed reportable incidents scheme generated the strongest response from industry leaders, with both ACSA and LASA saying it would duplicate existing reporting requirements.
“While we understand this issue being raised, there are already checks and balances within the aged care regulatory system and within individual organisations’ employment practices, such as police checks, accreditation and the Complaints Commissioner, to protect residents and clients,” ACSA CEO Pat Sparrow said.
LASA CEO Sean Rooney said any additional reporting requirements would need to be considered holistically to ensure they will achieve the desired outcomes and do not increase additional red tape.
The proposal to legislate against aged care providers requiring that a resident has a legally appointed a substitute decision maker for lifestyle, personal or financial matters also goes against recommendations by the industry to the inquiry.
While submissions to the inquiry from both the aged care associations and the Australian Bankers’ Association emphasised the need for ways to support cross-sector collaboration between aged care, community care and financial institutions to address elder abuse, the ALRC has not proposed any recommendations to enable this.
Mr Westenberg said elder abuse is an issue that can only be addressed in collaboration.
“An effective response will require very broad societal efforts; in the aged care space, it is essential that government work with providers to support quality of life for older Australians,” he said.