WA Senator Rachel Siewert chaired a Senate inquiry into aged care five years ago. Nothing has changed and it has costs lives. She shares her views here.
The outbreaks of COVID-19 in Australian aged care facilities have exposed a system that was broken long before the pandemic arrived as evidenced by the ongoing Royal Commission.
Despite clear warnings from overseas and the terrible outbreaks in Victoria, we still have no overall strategy to prevent COVID-19 in aged care facilities. The Government’s approach has been, at best, a series of ad-hoc funding announcements thrown at the crisis with little, if any, transparency or accountability.
One of the issues that this pandemic has clearly reinforced is the failure over years to address workforce issues. There have been countless reports. I chaired an inquiry responsible for one of those reports but recommendation after recommendation has been ignored and remain unimplemented.
Across the country and particularly in Victoria, the casualised, underpaid and under-trained aged care workforce played a role in spreading COVID-19 across facilities. This was because aged care workers had to work across multiple facilities to earn a living, didn’t have enough Personal Protective Equipment, were not adequately trained in infectious disease control, didn’t have the clinical leadership and didn’t have the workforce numbers to meet demand.
Years of under-investment in aged care, on top of a drive for profits by for-profit providers, only makes this situation worse.
It’s clear that the infection control procedures put in place in residential aged care haven’t been up to scratch for a long time.
Success story
In 2019, 837 older Australians died from influenza in residential aged care facilities. This year only 28 older Australians have died from influenza to date. The improved infection control procedures put in place to fight COVID-19, have highlighted what can be done to prevent deadly outbreaks of other diseases in aged care.
The government has known about problems with the aged care workforce and inadequacy of care provided for years. Facilities still do not have the right staff mix to look after older Australians and prevent future outbreaks. There are not enough staff with appropriate qualifications to provide clinical care, infectious disease control and this is compounded by a lack of training.
The truth is that most residential aged care facilities don’t provide enough hours of care to residents. We need massive investment in the workforce to increase the hours of care provided to residents (which means more staff), increase pay for aged care workers by 15% and an adequate mix of staff skills to provide the level of care needed, including having at the very least one registered nurse working 24 hours a day, seven days a week in all aged care facilities.
If we are going to protect older Australians from the spread of COVID-19, we must invest in our workforce. Not only are we failing older Australians but we are ignoring an entire area for economic growth – our caring economy.
Here in WA we have been fortunate so far but we cannot be complacent and it doesn’t mean that we can’t learn lessons from the outbreaks in other states.
Lesson not learnt
The things I am saying are not new and it’s incredibly frustrating that they have to be said again and again and that we have ended up in such a desperate situation. Australians are horrified by how rapidly COVID-19 spread through aged care facilities.
In my opinion the Aged Care Quality and Safety Commission has not taken a strong enough approach in assessing and monitoring facilities during the pandemic.
The commission has focused on assessing a providers’ readiness through self-assessment via online assessment tools and telephone calls. Guess what – most in Victoria thought they were ready! How is self-assessment appropriate in the middle of a pandemic?
I am certain the commission does not have the resources nor the staff to conduct face-to-face risk-assessment and infection control audits of every facility in Australia. In fact, the Australian Defence Force have conducted more checks on aged care facilities than the commission.
As at September 11, 2020, the commission had only visited 11 residential aged care facilities in WA to check their infection control procedures. Without more checks and audits, how can we know if we are prepared for COVID-19 outbreaks in WA?
Bureaucracy fail
We have known about the tick-box approach to assessing aged care providers against the standards for years now. People who has worked at a residential aged care facility will tell you that quality assessors are not adequately equipped to do their jobs.
This government has again failed older Australians and their families by failing to bolster staffing and resources for the regulator.
The Government cannot use the excuse of the Royal Commission not to act and must include significant reform measures.
After more than 35 public reviews of the aged care sector in 40 years, we need to reform aged care so that older Australians and their families can age with dignity.