2023 – a year in review: part 1
It was a year of momentous change for the aged care sector as major reforms came into play.
The year got off to a pessimistic start when a sector insider predicted that the aged care sector could see up to 50 homes close over the next 18 months.
“There could be somewhere between 30 and 50 home closures on the cards,” Grant Corderoy – senior partner at StewartBrown – told Australian Ageing Agenda.
Mr Corderoy’s grim forecast followed the release of StewartBrown’s Aged Care Financial Performance Survey which showed residential aged care in a “critical financial sustainability position.”
Meanwhile, another survey – from the Department of Health and Aged Care – showed that providers were only moderately aware and prepared for the raft of reforms taking effect later in the year including mandatory care minutes, 24/7 nurses, revised quality standards, and new governance requirements.
It found the majority – 71 per cent of residential aged care providers and 72 per cent of home care providers – felt only “somewhat prepared” for reforms they identified as having a high impact on them.
Unions, along with other stakeholders, made submissions to the Fair Work Commission calling for its interim offer of a 15 per cent pay rise for direct care workers to be paid in full without delay. The demand followed an announcement by the federal government that the wage hike would be passed on in two stages: 10 per cent from 1 July, and the other 5 per cent 12 months later.
February
The pay rise debate rumbled on with the government asking the FWC to extend its offer to include head chefs and cooks, and recreational activities officers. The move followed widespread criticism from peaks, unions and other stakeholders over the FWC’s decision – which had received Commonwealth support – to only offer nurses and personal care workers the wage increase.
Days later, the FWC capitulated and broadened the deal. The commission also announced that the 15 per cent pay rise would be paid in full, in one go, effective from 30 June.
The good news was followed by bad when provider peak the Aged & Community Care Providers Association announced that the aged care sector was in an even worse situation than stakeholders thought.
ACCPA was responding to the government’s first quarterly financial summary of the industry which showed that 66 per cent of aged care homes operated at a loss for the period July to September 2022.
Speaking to AAA, ACCPA CEO Tom Symondson said the financial snapshot mirrored reality. “The QFS reflects what the sector has been saying for some time – providers are struggling.”
March
The month began with confusion and uncertainty still surrounding the incoming home care reforms then slated for 1 July 2024.
Speaking during a webinar hosted by AAA, industry experts voiced concerns that providers were still processing the limited information available to try to make sense of the government’s plans.
“There’s a lot of reading of tea leaves going on across the industry at the moment,” said panellist and principal consultant at Pride Living Jason Howie.
Two of Australia’s leading aged care providers – BaptistCare NSW & ACT and Baptistcare WA – merged to create one of the largest not-for-profit operators in the country.
In a joint statement, Baptistcare WA chief executive officer Amanda Vivian and BaptistCare NSW & ACT CEO Charles Moore said the merger would enable the combined organisations to deliver more sustainable care. “Strategically, this merger allows two like-minded, well-governed organisations to join forces and be stronger as one,” they said.
The draft National Aged Care Accommodation Design Principles and Guidelines revealed four key design principles to guide the development of new homes and refurbishment of existing facilities:
- enable the person
- cultivate a home
- access the outdoors
- connect to community.
The principles will form the core of the government’s Residential Aged Care Accommodation Framework due to commence from 1 July 2024.
Unreasonable use of force topped the first SIRS report. Published by the Aged Care Quality and Safety Commission, the report showed nearly two-thirds of cases recorded during the first 15 months of the Serious Incident Response Scheme – 1 April to 30 June 2022 – concerned unreasonable use of force (62 per cent).
“Information we receive from SIRS notifications shines a light on the incidents that are occurring in aged care services and, importantly, the actions that providers need to take to mitigate the risks that come with caring for frail older people,” said commission chief Janet Anderson.
StewartBrown’s prediction of a wave of home closures proved true when three providers announced they were ceasing operations within weeks of one another.
The first, Queensland-based Blue Care, announced it was shutting its Millbank site in Bundaberg in June due to pandemic pressures. “While disappointing for Blue Care, our people, residents and their families, we acknowledge the impact of Covid-19 on the aged care workforce as a whole and many regional towns in particular,” the non-profit said in a statement.
The announcement prompted the Australian Workers’ Union to call for staff to be redeployed.
“In a time when local aged care workers’ workloads are already stretched to the limits it makes no sense for Blue Care to not step in now and commit to protecting local aged care jobs and their existing hours,” said AWU Central Queensland district secretary Tony Beers.
April
Six new categories were added to the National Aged Care Mandatory Quality Indicator Program on 1 April:
- activities of daily living – the percentage of care recipient who experienced a decline in activities of daily living
- incontinence care – the percentage of care recipients who experienced incontinence-related dermatitis
- hospitalisation – the percentage of care recipients who had one or more emergency department presentations
- workforce – the percentage of staff turnover
- consumer experience – the percentage of care recipients who report ‘good’ or ‘excellent’ experience of the service
- quality of life – the percentage of care recipients who report ‘good’ or ‘excellent’ quality of life.
Promoting the introduction of the new QIs on social media, Minister for Aged Care Anika Wells said: “We’re shining a new light on the quality of aged care.”
Yet another financial report from StewartBrown spelled gloom and doom for the industry. The benchmarking firm’s Aged Care Financial Performance Survey Report for the second half of 2022 showed the average operating results for aged care homes across Australia was a loss of $15.98 per bed per day – up from $10.31 the previous year.
Crunching data from 1,138 aged care homes, the report confirmed the ongoing economic decline of the sector, with many providers “at a critical financial sustainability position.”
Wesley Mission announced it was shutting all of its Sydney aged care facilities. Following the closure of Wesley Tebbutt in Dundas in north-west Sydney in 2022, a review of operations led the not-for-profit provider to close its remaining sites at Sylvania, Carlingford and Narrabeen. A “challenging environment” was cited as the reason behind the decision.
Days later, Perth aged care provider Brightwater Care Group announced the closure of three of its facilities. Citing difficulties in meeting incoming staffing mandates, Brightwater said it was shutting its sites in Joondalup, Huntingdale and South Lake within 12 months.
“Modelling of our rosters to meet the new minimum staffing requirements has shown that our smallest facilities will not be best placed to deliver the quality of care we pride ourselves on in a financially sustainable way,” said Brightwater chief executive Catherine Stoddart in a statement.
At the month’s end, ACCPA CEO Tom Symondson told delegates at the peak’s inaugural state conference in Queensland that the sector was unprepared for the implementation of the new home care program.
With the new system due to kick in from 1 July 2024, Mr Symondson expressed doubts that providers could meet the deadline. “We’re very concerned about that and the level of detail that we still do not have about the future of Support at Home,” he said.
