The Australian public increasingly lacks confidence in the aged care sector. Which is not a surprise when stories of elder about, neglect and poor quality care is reported on a regular basis all around the country.
So how can the industry move forward and improve at a time like this? Like any balance analysis, you need to look at things for multiple angles. In the case of aged care, you have to look at consumers – the residents and their families – and the providers – the aged care facilities and their staff.
The Consumer Perspective
While there are plenty of example of excellent care and service, there is a lot more just passable and mediocre care than most providers will admit.
There are also too many failures, not all of which see the light of day.
Consumers lack confidence that providers will address these failures on their own – mainly because too many have not.
This leads consumers to call for more regulation and oversight.
Consumers also see a lack of competition. Poor providers are protected by bed licences. Good providers can’t grow as quickly as consumers want.
Consumers want to see regulation changed to promote competition so that great providers are rewarded and poor providers disappear.
They also want to see regulatory oversight to protect the vulnerable and to protect consumers until provider behaviour improves.
Aged care residents and their families have also said they want to see more codesign where providers genuinely engage with consumers in developing aged care services.
The Provider Perspective
Most providers work hard in a tough environment to provide great service.
It is believed that in the vast majority of cases, providers deliver very good to excellent outcomes.
However, there is no agreed way to measure these outcomes and to reward those providers who out-perform or over-perform.
The current regulatory environment promotes a compliance culture and discourages innovation or the delivery of value-added services.
The key to good aged care is that it’s delivered by people. There has been an underinvestment in people, leadership, education and culture.
Some stakeholders even argue that the debate about staff ratios does not cover off this point, rather, it tends to mask the key issues.
There is insufficient investment in obtaining customer feedback early and often and addressing and using it. Feedback is generally received post failure and often in a highly charged atmosphere.
The Way Forward
1. Changes in regulation
Deregulate the supply side (bed licences) to enable competition to develop in real terms – based on consumer demands.
In return modify demand-side regulation to promote innovation allow price differentiation on a fair and equitable basis.
Enhance consumer protections through stronger oversight including unannounced visits regime and new Commission.
2. Engage consumers
Design products and services using codesign principles.
Genuinely involve residents and relatives in the management of residential aged care facilities.
Proactively gauge customer satisfaction and act on the feedback. People know what they want, and they understand what does and doesn’t work for them.
3. Invest in people
Develop and support leaders. Most failures can be traced back to poor leadership and poor communication.
Attract high-quality clinicians. Don’t put struggling nurses in positions of responsibility. This requires all stakeholders to work on an effective strategy.
Create new career pathways that support and incentivise people from the entry level care worker upwards.
Investment in continuing education is key. There are new researches and new theories of care, the industry should stay up to date and encourage their staff to upskill.
4. Address culture
Be transparent in everything if this comes at a short term cost. Includes complaints, failures, challenges and successes.
Engage all consumers – residents and families. This requires clear and consistent strategies, not just good intentions.
Determine and live values. Respect is core – respect for the families, respect for the staff and, most importantly, respect for the residents.
As discussed at the recent Criterion/COTA conference – Quality in Aged Care.
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