INDUSTRY UPDATE – NOVEMBER

Nearly the end of the year, and a lot happening in the Aged Care space. November saw a great deal of news surrounding the release of the Royal Commission Interim report, with the Government, Industry and public reactions. Chemical restraint was once again a significant topic in November, as well as the continuing concern of funding in the sector. Tech, innovation and dementia news had a huge part in positive news in the sector, with important studies and new inventions looking to enhance healthy ageing. The state of Queensland had a busy month, introducing new laws and the final report on Earle Haven; and Royal Commission hearings again highlighted the additional issues that Regional Aged Care faces. It is time to review the month that was in Aged Care – here is your update for November.

ROYAL COMMISSION INTERIM REPORT

With the release of the Royal Commission’s Interim Report on 31 October, the Industry shared their responses, and awaited the Government’s response.

Minister for Aged Care and Senior Australians Richard Colbeck reacted to the report by stating that he was shocked with the findings, and that the report would be putting the Government, the Industry and the community on notice.

With three areas identified as requiring immediate and urgent action (increased home care packages to tackle the current waiting list; changes to how chemical restraints are used; and removing younger people living with disabilities from an Aged Care setting) the sector also called for new funding solutions and the addressing of urgent workforce needs. However, a significant increase in funding prior to the end of the Royal Commission has been rejected by the Commission’s report, under the notion that it would be another short-term solution when major reform and a transformation of the Aged Care system needs to take place first. Regardless, Prime Minister Scott Morrison promised the sector additional funding prior to Christmas, and on 25 November, released an official response to the Interim Report, announcing a $537M funding package for the sector. The funding will primarily specifically target the three areas identified in the report as requiring drastic change, as well as a focus on dementia training and support.

Following the interim report, a legal expert has called for the Royal Commission to reference human rights violations in the industry, stating that the report refers to many instances of such. Professor Andrew Byrnes is a professor of law at the University of New South Wales Australian Human Rights Institute, and has also said that the issue of ageism was not factored into the report. Australia’s Human Rights watch has called for the Government to act on the report’s findings and protect older people living in care from chemical restraint, amongst other treatment.

Labor’s spokeswoman Julie Collins has described the Government’s response as ‘inadequate’, stating that 16,000 older Australians had died in 12 months, whilst they waited for a Home Care package.

ROYAL COMMISSION UPDATE

November saw two hearings take place: The Mudgee, NSW hearing from 4-6 November, focusing on the Provision of Aged Care in regional areas; and the Hobart hearing from 11-15 November, which inquired into the operations of selected Providers in the state.

The ABC reported in November an imbalance in media coverage of the Aged Care Royal Commission in comparison to the Banking Royal Commission, suggesting that the media disengagement may also reflect the public interest.

The November Mudgee hearing focused on the provision of Aged Care in regional areas, with witnesses highlighting the additional issues that regional Providers face – such as finding appropriately qualified Registered and Enrolled Nurses.

The Hobart hearing focused on the operation of selected Tasmanian Providers, with a number of witnesses presenting evidence of lower levels of care as a result of staffing cuts and strategies implemented to save money and management.

December saw the final hearing of the year in Canberra from 9-13 December, with a focus on the interfaces between the Aged Care and Health Care systems. You can keep up to date with the hearing dates and topics here.

With a great deal of media reports surrounding the Royal Commission, the Aged Care GuideAustralian Ageing Agenda and The Weekly Source are excellent sources of information. You can also access live and past hearings via the Royal Commission webcast channel here.

CHEMICAL RESTRAINT

Chemical restraint in Aged Care was once again a big topic in the month of November, particularly highlighted by the Royal Commission’s interim report that targeted the reliance on chemical restraint as a key area for immediate action. Australia’s Human Rights Watch have been campaigning for action and changes to Aged Care regulation to prohibit chemical restraint. The release of a report by the Australian Institute of Health and Welfare (AIHW), Interfaces between the Aged Care and Health Systems in Australia – First Results, also shared data on the average number of days that Residents in Australian Aged Care Facilities on antipsychotics exceeded the World Health Organisation’s (WHO) recommended number of days. Importantly highlighted by Aged Care 101 is the fact that Residents can only be prescribed medication by a GP, and then a pharmacist will need to provide the medication.

A mid-November parliamentary committee recommended that the recent legislation, Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019, concerning restraints in Aged Care, should remain in force but be amended. The suggested amendments concerned the clarification of consent, further consultation with stakeholders, obligations to exhaust all alternative options, and mandatory reporting for restraint use.

As a part of the Government’s $537M funding package for Aged Care, $25.5M has been designated to medication management programs and education to reduce the use of chemical restraints, alongside an additional $10M for more dementia training and support.

GEN AGED CARE DATA

The Government’s latest Gen Aged Care data report, the 2018–19 Report on the Operation of the Aged Care Act 1997, was released in November. Media reports shared the report data that the number of assaults in Aged Care facilities has almost doubled in 12 months; as well as there being a increase in ACFI downgrades and facility sanctions. The number of approved Providers dropped from 902 to 873; whilst Home Care Providers increased from 702 to 928. The report aims to detail the operation of Aged Care in Australia over the 2018-19 financial year. You can read the full report here.

HOME CARE

To Home Care news, and as shown in the 2018–19 Report on the Operation of the Aged Care Act 1997, Home Care Providers are now in greater numbers than Residential Care Providers for the first time. Despite the growth of the sector, the Royal Commission has noted the lack of information available to consumers on care options. However, a new publication from DPS, an Australian multiplatform aged care media company, aims to guide older Australians through the different paths available for getting support in the home. The ‘DPS Guide to Home Care’ intends to make information more accessible to older people looking to navigate the system, and a copies for purchase can be found here.

10,000 additional Home Care Packages were announced as a part of the Government’s recent announcement of a $537M funding package for Aged Care.

DEMENTIA

To dementia news for November, with a lot happening in this space as always. To dementia research first – and a review of studies into non-medical treatments has found a number of alternative methods of managing dementia related systems were just as effective (or even more so) as antipsychotic drugs. The report, Comparative Efficacy of Interventions for Aggressive and Agitated Behaviours in Dementia: A Systematic Review and Network Meta-analysis, highlighted music therapy and massage as extremely effective at treating symptoms such as aggression and agitation.

A new resource launched by The Cognitive Decline Partnership Centre is now available to guide and support workers in Aged Care. The guide, People with dementia: A care guide for general practice, will assist those working in Aged Care, including Nurses, Doctors, Allied Health and Pharmacists to provide the best ongoing care for people living with dementia.

The National Framework for Action on Dementia 2015-19 is currently open for evaluation via a public consultation. The Framework guides development and implementation of actions, plans and policies in regards to dementia to improve overall l outcomes. Consultation is open until Tuesday 31st December 2019. You can take part in the process by completing the survey here.

A new cottage-style dementia-specific facility is going to be built in Adelaide, as a joint project between Aged Care Provider Hammond Care and SA Health. The facility will have 78 beds, and will be designed to care for those with complex needs, whilst creating a village like environment. Four cottages will house 15 residents in single bedrooms with ensuites, and two cottages housing nine Residents. The Adelaide facility will be South Australia’s first Specialist Dementia Care Units under the Federal Government’s Specialist Dementia Care Program.

And finally for dementia news, a fundraising initiative raising money for a dementia community bus service in Western Australia has launched a new recipe book available for purchase. Not-for-profit Perth based organisation Community Vision has released the book, Recipes to Remember, to raise funds for the expansion of the community bus service across Western Australia. The service visits locations all across the state, providing opportunities to the community access to innovations such as Virtual Reality, as well as the bus itself being fitted with sensory materials and the service offering respite for carers. The recipe book is filled with recipes from twenty-two celebrities. You can read more about the Community Vision fundraising program, A Roast to Remember, here.

EARLE HAVEN REPORT RELEASED

The report of the inquiry into the Earle Haven facility , which was suddenly shutdown in July 2019 with all Residents requiring emergency relocation, was released in November. The Report, led by Ms Kate Carnell AO provides 23 recommendations, all of which have been supported by the Federal Government. The inquiry recommendations endeavour to stop similar sudden closures in the future, including greater regulatory capacity and coordination.

The full report, Inquiry into events at Earle Haven, can be read here.

HEALTH TRANSPARENCY BILL PASSES IN QLD

November saw the passing of the ‘Health Transparency Bill 2019’ in Queensland, which will affect all public Health and Aged Care Facilities in the state. Introduced to Queensland parliament in September 2019, post the sudden closure of Earle Haven, the Transparency Bill will mean that Queenslanders have more information on hospitals and Facilities when looking for a service. Dubbed a ‘TripAdvisor’ for Healthcare, public organisations will need to upload such information about their Facilities to a website; whereas Private Organisations will be able to opt-out. The Bill requires Residential Aged Care Facilities to report average daily Resident care hours each quarter, as well as requiring a minimum of 30% of all care staff to be Registered Nurses, and a minimum average of 3.64 hours of care provided to each Resident per day.

Queensland is the first state in Australia to have mandated staff-to-Resident ratios, a topic of much ongoing debate. The Victorian State Government was reported to also be pushing for staff-to-Resident ratios in November.

You can read the full Bill here.

INNOVATION & TECH NEWS

Another month of exciting innovation in the Aged Care and Aged Care tech space! Let’s dive into what new inventions were in the news in November:

  • Three Queensland-based Entrepreneurs have joined forces to create an AI technology that monitors the safety of people at home, identifying falls and sending an alert for help – but without breaching privacy as it doesn’t require a camera, requires no Wi-Fi or internet connection, or even individual programming. In fact, the small device’s technology is based on it ‘learning’ to recognise objects and abnormal behaviours. You can read more about the tech, HomeGuardian.ai, here.
  • Peak bodies Aged & Community Services Australia (ACSA) and The Aged Care Guild have partnered with the Digital Health Cooperative Research Centre (Digital Health CRC)  to create ‘The Living Better Lab’. The union intends to help drive innovation and technology in the Aged Care space in an effort to continue to improve the lives and care of older Australians. The lab will be a platform for trialling innovations and enabling research, design and development to take place.
  • A new mentoring program has also been launched in November by The Aged Care Industry Information Technology Council (ACIITC) and Minister for Aged Care and Senior Australians Richard Colbeck. The ACIITC is a joint venture between peak bodies ACSA & Leading Age Services Australia (LASA), and the mentoring program aims to bring together mentors and mentees to foster capacity for technology and innovation in the Aged and Community Care sectors.
  • An initiative in Singapore to enable pedestrians who require extended time to cross the road as a result of disabilities or reduced capability of movement has been suggested as a great idea to implement in Australia. The initiative, created by the Singaporean Land Transport Authority (LTA), means that more than 400 pedestrian crossings in Singapore are equipped with a sensor, that elderly and disability concession card holders can tap, extending the ‘green man’ time to allow more time for crossing the road. The sensor is adequately titled ‘Green Man +’, and has been running in Singapore since 2009.
  • ‘Sci-fi’ style retirement village apartments are now a thing of the present – with retirement village Provider Stockland launching a ‘smart’ apartment in Sydney. The apartment performs a number of actions based on voice commands, such as operating lights and blinds, but also sends alerts if a bathroom door is not opened after a certain period of time.
  • A new interactive technology is being rolled out by Aged Care Provider Opal, featuring games, meditation exercises and programs based around interests. The tech is an interactive projection, and allows people to experience and interact with displays that project on to the floor. Studies have shown that such interactive technology can be very beneficial in increasing happiness (through the release of dopamine) and improving memory.
  • There continues to be a number of tech and robotic innovations designed to help with companionship, assist decreasing feelings of loneliness or even undertaking extra tasks so that Aged Care workers have more time to spend with Residents.
  • A new app is being developed at the University of New South Wales in Sydney, that will analyse speech to test for the early signs of dementia. The app has an accurate diagnosis rate of 97.2%, whereas current dementia screening involves tests and interviews that relies on Doctor expertise and the person’s condition. Whilst the app is only in the early stages of development, project lead Dr Beena Ahmed hopes that it will enable early detection of the disease, meaning earlier treatment to delay the onset of symptoms.
  • Finally in tech news, a potential solution to the issue of bedsores has been developed, with the aim of enhancing the lives of people who are immobilised. The practice of ‘repositioning’ has been a topic of great contention over the past few years (in regards to timing), and the new ‘Freedom Bed’ is an automated rotational bed, programmable and controllable by voice, that can set position times anywhere from one minutes to 4 hours. The bed can also rotate its occupant any angle between 5 and 30 degrees (with the total range of rotation being 60 degrees).
NATIONAL REGISTRY FOR CARERS

A new National Registration Body for Aged Care Workers was launched in November by the Australian College of Care Workers (ACCW). The registration body is currently voluntary, but will only accept members who meet the requirements, including a certain level of qualifications, a minimum number of hours of work experience and identity checks and documents. The registry will also require 20 hours of continuing professional development (CPD) to be undertaken each year, with the aim of continuing to improve care. Industry Peak body Leading Age Services Australia (LASA) has spoken in support of the national register, stating that it will help to protect older Australians and employers.

FUNDING

Once again, the crucial issue of funding in the Aged Care sector was highlighted in the media in November, with the Royal Commission hearing that not-for-profit Aged Care Facilities in rural areas were at risk of closing down. Rural Providers are at great risk due to higher costs, with fewer income sources, as was asserted by Peter Gray QC, special counsel assisting the commission. The issue was further highlighted by an investigation into publicly available financial reports of Aged Care Facilities by peak body LASA, that found 197 Providers were at the risk of closure. As reported in our October Industry Update,  the latest StewartBrown report continues to show a decline in the average net profit of Aged Care Facilities. You can read the full report here.

REGIONAL AGED CARE

With the November Mudgee hearing focused on the provision of Aged Care in regional areas, the issues that regional Providers face was widely reported last month. In addition to the Royal Commission hearing that not-for-profit Aged Care Facilities in rural areas were at risk of closing down, it was reported that people living in rural and remote areas were not provided equal access to Aged Care services. Witnesses highlighted additional issues that regional Providers face – such as finding appropriately qualified Registered and Enrolled Nurses. Potential recommendations to help address the additional issues that regional Aged Care Providers face were the focus of the second day of the Mudgee hearings. A panel of regional Aged Care Providers heard suggestions of potential solutions from the Commissioners, where they were able to comment on thoughts about their effectiveness.

In positive news, a program at the Kapululangu Aboriginal Women’s Law and Culture Centre in Balgo, Western Australia, is looking to challenge some of the issues faced by regional and remote areas, as well as providing culturally appropriate care. The program seeks out local women to train them as carers, enabling the ability to keep elders on country, and allowing them access to culturally appropriate care.

Finally for regional news, a new two year education program that upskills Allied Health professionals to work in regional areas, including work with older people, was announced by the Government in November.

LGBTI FACILITY A FIRST FOR QLD

November saw a first in the state of Queensland, with the opening of Arcare’s Parkwood LGBTI Facility. The Facility is open to the wider community, but will provide specialised care for LGBTI people, under the Government’s program aimed at prioritising services for special needs groups such as the LGBTI community. The Facility is the first of its kind in Queensland, and the opening saw more than 650 people come to celebrate.

LONELINESS AND SOCIAL ISOLATION

Social isolation has long had both health and mental health risks associated with it; and there is a strong relationship between loneliness as an indirect cause of hospitalisation.  Aged Care Residents continue to be at a greater risk of mental illness as a result of the disruption to their lives and continued isolation. However, Aged Care homes can also give people a greater opportunity to connect with others, especially if they have been living at home alone, as this story from Tasmania shares.  Another great example is not-for-profit Aged Care Provider Benetas aims to approach their facility design as a home first, where eight Residents live together in apartments with shared areas and the support of a carer.

‘ADOPTING’ AN OLDER PERSON FOR HOLIDAYS

From loneliness in Aged Care to a story of reducing isolation during the holiday season. In America, a program simply called ‘Adopt a Senior’ enables families to do just that – ‘adopt’ an older person living in care without family who may not have the money to purchase ‘extra’ items such as socks. These people are often also without visitors, which can be especially difficult over the holidays. Founder Danielle Burleson thought that it was a great way to give back to older people who may be experiencing loneliness over the holiday period, as well as providing them with much needed items. Although this is an Arizona, US based program , you can view the details here. What an amazing idea!

To another innovative US-based program, with a new company that couples comedians with people living in care – with the aim of using laughter as ‘medicine’ for those living with dementia and Alzheimer’s. The program, ‘Laughter on Call’, hires comedians to visit a Resident living in care who they are paired with. The company also organises laughter workshops and live comedy shows. The benefits of laughter are well documented, and a number of studies support laughter as an important aspect of interacting with people living with dementia and Alzheimer’s.

That’s all for this month but check back in with us next month for another industry update!

 

Kelly LISSIE LYONS – CHAMPION OF EDUCATION & MARKETING
Author

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