The interim report of the Royal Commission into Aged Care Quality and Safety describes a system that must be urgently changed, with systemic failures in access to services, substandard care delivery, a lack of leadership, and regulatory processes that are not fit for purpose.
These issues are exacerbated by an overworked, underpaid and poorly trained workforce and the need for a sustained and strategic approach to change according to the Caring Futures Institute at Flinders University.
While the interim report has highlighted three areas for immediate action, there are also clear signals that the final report will seek to comprehensively address the design, objectives, regulation and funding of aged care in Australia.
Matthew Flinders Fellow Professor Julie Ratcliffe says the interim report contains heartfelt stories of neglect and poor care and statistics which indicate that there are fundamental problems.
“Evidence-based practice is the key to achieving transformational change and the improvement in outcomes for the most vulnerable in our society including people in aged care. Translation and impactful research is badly needed to support the culture change that is needed. The Caring Futures Institute is working in partnership with aged care consumers, service providers and policy makers to deliver new consumer focused metrics urgently needed for measuring and improving quality of care and quality of life,” says Professor Ratcliffe.
“Investment in a skilled and capable workforce is essential. Training and education are critical and should be based on best practice evidence and on the best evidence about workforce development and organisational change.”
The Caring Futures Institute is the first fully dedicated research institute in Australia to commit to unravelling the complexities and practicalities around care – and several of its researchers have already provided submissions or evidence at Royal Commission into Aged Care Quality and Safety hearings.
The interim report and publicly available transcripts give an indication of key areas of research priority in Australian aged care systems. Equally important are the underlying processes such as knowledge translation and implementation strategies that will embed change and drive innovation to provide new frames of reference for the future.
The potential for meaningful digital solutions to enhance better consumer outcomes is an area of focus for the Caring Futures Institute.
“There is great scope for better development and application of digital tools that would lead to more effective community and consumer experiences as well as improved quality of life outcomes for older Australians,” said Professor Ratcliffe.
The interim report also highlights that palliative care and end-of-life experiences for older Australians is an issue. Skilled and experienced staff with more time to provide care and communicate with older Australians and their families about end of life needs and preferences is critical.
“The Caring Futures Institute can significantly contribute to the knowledge about what works in the context of Australian health and aged care systems, as we work towards person-centred, flexible and culturally appropriate end-of-life care in both residential and home care services,” said Professor Ratcliffe.
Researchers at the Caring Futures Institute will be keenly awaiting next year’s final report and hope to see strong recommendations around workforce and service development, a comprehensive evaluation framework, strategic research priorities, community engagement, revised training programs, and minimum requirements for technology in aged care.
Caring Futures Institute recommendations
- Address the current lack of an evidence-based approach to aged care services provision and practice.
- There is a need to further integrate research from co-design to translation working in close partnerships with consumers and service providers. This must include the development of validated and meaningful outcome measures relevant to the older person.
- There is a need for evidence-based practice enabled by a strategic research plan and strategic research partnerships which support and enable interactions between researchers, policy makers, and service providers.
Skills/training
- There is a lack of appropriate training for aged care workers, nurses, and allied health professionals. Retraining is required to enable the delivery of fundamental and care models which maximise the wellbeing and quality of life of older people accessing aged care
- Training and education approaches should be tracked for effectiveness of care delivery and consumer outcomes not just knowledge change.
- There is a need to address the appropriate skills mix for personal and clinical care in residential care and in the community.
Governance and systemic change/benchmarking and frameworks
- There is a need for systemic and attitudinal change within the care workforce and the professional workforce.
- There is a need for universally agreed governance and practices that could be driven by an evaluation framework for best practice of care, effectiveness and cost-effectiveness measures of services and supports.
- There is a need to address the lack of mandated staff ratios in residential care.
Personalised-care model
- Personalised care-models to be adapted that recognises the person in their context and that care is provided in a manner that is sensitive and culturally appropriate to the preference and needs of the person.
- Community engagement is required so that service users, families and carers voices are represented in all stages of research, evaluation-design and implementation.
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We are leading a reform agenda where ‘care’ is the focus for aged and disability care sectors: where quality care is accessible to all, and where person-centred care and trusted relationships are paramount.