Regulator needs to better engage with sector, says report

The aged care watchdog needs to interact more with the sector, according to an independent review.

Released on Friday, and authored by David Tune, the report makes 32 recommendations to bolster and rebuild the Aged Care Quality and Safety Commission.

“These will ensure that the commission is best placed to deliver the future regulatory framework that will apply when the new Aged Care Act commences on 1 July 2024,” writes Mr Tune.

Among Mr Tune’s recommendations: the commission must “engage more openly and work with providers. It must build on its recent good work engaging with consumers and providers – but go much further.”

The commission, adds Mr Tune, “must acquire a far more collaborative approach … partnering with providers and peaks and utilising opportunities for codesign with providers and consumers.”

It must also share much more information and data – “on its own performance, but also providers’, and what works, and what the key issues are. This will help drive ongoing continuous improvement and enable a more trusting and empowered sector.”

As well, the commission must improve communications with the Department of Health and Aged Care “to ensure priorities are better articulated and understood … this is of critical importance for matters like education and support for providers.”

A recommendation of the aged care royal commission, the capability review of the sector’s regulator was announced by the Albanese Government in July last year after the Coalition Government failed to act on the commission’s advice.

The review was conducted in consultation with stakeholders across the aged care sector including providers, peaks, consumers, the commission and advocacy groups.

In the 115-page report, Mr Tune – who has undertaken several reviews of the aged care system in the past, including the Legislated Review of Aged Care in 2017 – assesses the commission’s strengths and weaknesses “and the extent to which these inhibit or enable a best practice regulator.”

“The complaints process must be urgently reviewed.”

Among the weaknesses, the commission’s complaint processes – including the Serious Incident Response Scheme.

“The complaints system must be urgently reviewed,” writes Mr Tune, “to ensure that complaints are triaged appropriately, that complainants have assurance that concerns are being followed up, and the wider community gain trust that matters of concern to older Australians and their families are getting priority attention.”

There must also be “regular and more detailed reporting on complaints and SIRS.”

“This,” adds Mr Tune, “is a huge workload, and the appointment of the new Aged Care Complaints Commissioner must proceed as a high priority.”

Mr Tune also notes that ­– since its inception in 2019 – the commission has faced “significant issues attracting and retaining staff,” particularly quality assessors. The commission currently has a staff vacancy rate of 20 per cent which, writes Mr Tune, “results in capability and capacity deficits.”

In addition to staff shortages, Mr Tune found that the commission’s ICT systems had “not kept pace with the growth in functions and staffing needs.” Both workforce and ICT “will need a sustained focus,” adds Mr Tune.

While acknowledging that the commission “is taking important steps to ensure that it evolves into a high-performing regulator,” Mr Tune writes “it is clear that there is much more to be done.”

“To become a trusted, high-performing regulator, the commission must, as a matter of urgency, take further action to fix its organisational structure, senior leadership, and internal governance.”

Mr Tune concludes: “If the commission does these things … I believe it will be set up for success.”

In a statement, Minister for Aged Care Anika Wells welcomed Mr Tune’s review. “I welcome the practical and constructive recommendations from Mr Tune and will be carefully considering each of them as a matter of priority.”

As a first step, Ms Wells has directed the department to establish a senior-level steering group to advise government “on prioritisation and implementation of the recommendations.”

Aged Care Quality and Safety Commissioner Janet Anderson will be a member of the steering group. In a statement, she said she is looking forward to implementing change.

The commission, she said, “is committed to working with all relevant stakeholders” – including people receiving aged care, providers and peaks – “to ensure that the changes and improvements we introduce will achieve the desired outcomes.”

Ms Anderson added: “We are determined to use the review findings and recommendations as a springboard to strengthen our capability to help lift the standard of care and overall performance of the aged care sector and boost the community’s trust and confidence in aged care services.”

The Older Person’s Advocacy Network welcomed the release of the review. OPAN CEO Craig Gear said the recommendations had the potential to improve older people’s faith in the government watchdog.

“A regulator that is fit for purpose is the cornerstone of a healthy aged care system,” said Mr Gear. “And by increasing the accountability of home care and residential aged care providers – and improving transparency of the regulator – we can further restore the confidence of older people and their families.”

Council of the Ageing Australia CEO Patricia Sparrow also responded to Mr Tune’s review. “There’s no question that we need to see culture change in the watchdog, and the sector more generally, to ensure rights are upheld across the entire aged care system.”

She added: “While the commission has a regulatory relationship with service providers, it must never be forgotten that it only exists to act on behalf of the community to ensure the safety and quality of the services provided to older people. Older people accessing aged care services must be front and centre in all considerations and developments.”

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