For those of us that pay close attention to the aged care sector, hearing the news that an aged care home has failed to meet accreditation standards is nowhere near as shocking as it should be.
There has been no shortage of aged care facilities having sanctions imposed upon them for failing to meet the basic standards of care, and the penalties that providers face for these failures seem to be doing very little to stem the tide of accreditation failures.
The Australian population is ageing rapidly, and the expected influx of older people needing residential aged care around the country is going to put even more pressure on an aged care system that is already well past its breaking point.
We need to be asking those running the industry if the sanctions on aged care providers that fail accreditation are actually meant to be a deterrent, or are things actually so bad at this point that they are being forced to value the quantity of available aged care providers over only wanting those who provide high-quality care?
Dr. Rodney Jilek has spent over three decades working in various roles across the Australian aged care sector, but his current role as the Principal Advisor at Aged Care Consulting and Advisory Services has him providing advice to aged care providers who have failed aged care accreditation.
This role gives Dr. Jilek a unique insight into the mindset of aged care providers who have failed accreditation, and he sat down with HelloCare to discuss the validity of current-day sanctions as a deterrent for those who are failing to provide quality care.
“Sanctions used to be the worst thing that could ever possibly happen to you, and it was seen as the end of the line when the time came that the department had to impose sanctions on you,” said Dr, Jilek.
“All of a sudden we have had a string of sanctioned homes in the last couple of years, and the attitude of some of the providers is ‘ahh well, these things happen, we will get over it.’ It feels as though some providers think of a sanction as a momentary blip on the radar. This is definitely not a generalization of all providers though, because even though some may take this stance, there are others that are genuinely horrified”
“Placing sanctions on a provider can be the wake-up call that they need which prompts them to get their act together and put in the resources to fix things, but on the whole, I don’t see current sanctions really improving the lives of elderly Australians because the responses are too variable and there’s no consistent monitoring of the homes.”
“I can be working at a facility that has been sanctioned and the department won’t even come to this facility once over six months. They have a weekly telephone call where a CEO can tell them anything they want.”
While the types of penalties that can result from a failed accreditation can vary, sanctions being placed on aged care providers usually last for three months and consist of making a facility appoint both a nurse advisor and administrator to oversee operations.
Failure to improve after this point can result in the revoking of ‘approved provider’ status, thus becoming ineligible to receive Commonwealth funding for new residents until sanctions have been lifted.
Despite all the talk of transparency in aged care, according to Dr. Jilek, the process of handing out adequate penalties for failing accreditation is shrouded in mystery.
“You have homes that fail two or three outcomes that are being sanctioned, and then you have others that are failing 20 outcomes who haven’t been sanctioned. There is absolutely no rhyme or reason as to who gets sanctioned and why, and each sanction comes down to the decision of one person – a health department delegate,” said Dr. Jilek.
“There are all sorts of questions that need to be asked about the relationship between every delegate in each state and the peak bodies and aged care providers that they deal with because the whole thing is extremely murky and there is no transparency at all.”
“Even when they decide to impose sanctions, that information is not available on their website for a couple of months. It’s all cloak and dagger stuff.”
“The time that sanctions last has been cut in half, providers get extensions on the time periods in which they have to bring things up to speed, and they even pick their own advisors, despite the fact that they failed to manage themselves in the first place.”
“It’s actually mind-boggling that the delegates in the Health Department can think to themselves ‘yep, this place failed accreditation horrendously but let’s trust them to fix things themselves.”
There have been a number of examples in the last year of aged care providers failing accreditation, and then managing to pass accreditation and have their sanctions lifted, only to fail accreditation again soon after.
From a distance, this would seem to suggest that some aged care providers are looking for a short-term solution in order to regain accreditation, rather than getting to the core of the issues and committing themselves to make positive changes.
According to Dr. Jilek, each provider responds to the news of a failed outcome differently, but reducing the imposed time of sanctions has removed the only real power that they actually possess.
“I don’t think that we have a lot of providers taking these sanctions seriously,” said Dr. Jilek.
“Sanctions used to be for six months, and they have been watered down now to three months in most cases. The department will say that the reason for that is the financial impact that this has on providers, but the financial impact is the only actual deterrent.”
“We have seen a number of providers who have no intention of fixing the issues at the root cause and instead push for band-aid solutions that mask the problem and are unsustainable. It is our experience in NSW that this approach is being allowed by the Department of Health and even when ongoing risks are raised with them by nurse advisors – they are being ignored.”
“The department, and the government more broadly, need to work out if they are serious about getting rid of aged care providers who are incapable of meeting the minimum standards of care for elderly people – because, at the moment, its seems that they are more interested in quantity than quality.”