Aged Care Legislated Review Sunnyside Lutheran Retirement Village
Aged Care Legislated Review – Sunnyside Lutheran Retirement Village
Table of Contents
1.Tell us about you
1.1What is your full name?
1.2What stakeholder category do you most identify with?
1.3Are you providing a submission as an individual or on behalf of an organisation?
1.4Do you identify with any special needs groups?
1.5What is your organisation’s name?
1.6Which category does your organisation most identify with?
1.7Do we have your permission to publish parts of your response that are not personally identifiable?
2.Response to Criteria in the Legislation
2.1Whether unmet demand for residential and home care places has been reduced
2.2Whether the number and mix of places for residential care and home care should continue to be controlled
2.3Whether further steps could be taken to change key aged care services from a supply driven model to a consumer demand driven model
2.4The effectiveness of means testing arrangements for aged care services, including an assessment of the alignment of charges across residential care and home care services
2.5The effectiveness of arrangements for regulating prices for aged care accommodation
2.6The effectiveness of arrangements for protecting equity of access to aged care services for different population groups
2.7The effectiveness of workforce strategies in aged care services, including strategies for the education, recruitment, retention and funding of aged care workers
2.8The effectiveness of arrangements for protecting refundable deposits and accommodation bonds
2.9The effectiveness of arrangements for facilitating access to aged care services
3.Other comments
1. Tell us about you
1.1 What is your full name?
-
1.2 What stakeholder category do you most identify with?
Service Provider
1.3 Are you providing a submission as an individual or on behalf of an organisation?
Organisation
1.4 Do you identify with any special needs groups?
People who live in rural and remote areas
1.5 What is your organisation’s name?
Sunnyside Lutheran Retirement Village
1.6 Which category does your organisation most identify with?
Aged Care Provider
1.7 Do we have your permission to publish parts of your response that are not personally identifiable?
Yes, publish all parts of my response except my name and email address
2. Response to Criteria in the Legislation
2.1 Whether unmet demand for residential and home care places has been reduced
Refers to Section 4(2)(a) in the Act
In this context, unmet demand means:
• a person who needs aged care services is unable to access the service they are eligible for
e.g. a person with an Aged Care Assessment Team / Service (ACAT or ACAS ) approval for residential care is unable to find an available place; or
• a person who needs home care services is able to access care, but not the level of care they need
e.g. the person is eligible for a level 4 package but can only access a level 2 package.
Response provided:
I believe that the unmet demand for Residential Care may have decreased slightly in the short term. There are 2 reasons for this. Firstly, the efforts to keep people in their own homes will have an impact until the needs outweigh that service’s ability to manage the person, and then the requirement for Residential places will be in similar demand to what was previously the case. Secondly, there is a great deal of confusion and anxiety in the community about the processes and costs to enter care that some people are ‘battling’ on their own. In our case, whilst the unmet demand that we experience has decreased (in my opinion), there is still unmet demand in this city and surrounding area.
2.2 Whether the number and mix of places for residential care and home care should continue to be controlled
Refers to Section 4(2)(b) in the Act
In this context:
• the number and mix of packages and places refers to the number and location of residential aged care places and the number and level of home care packages allocated by Government; and
• controlled means the process by which the government sets the number of residential care places or home care packages available.
Response provided:
Yes! I believe that there does need to be control over the number of places available. That is not to say that there should not be some improvement in the mechanism by which those controls are set, but there does need to be control. It has already been seen in Home Care, where services are moving into new areas in competition with existing services, which sounds good, however the reason this is happening is to return a profit, and not for the benefit of the people receiving the services. If the same thing were to happen in Residential Aged Care, the result would be a very much profit orientated system, with profit rather than care being the motivating factor. Particularly in rural areas, services would be set up to cherry pick the profitable areas, and everyone else would suffer.
2.3 Whether further steps could be taken to change key aged care services from a supply driven model to a consumer demand driven model
Refers to Section 4(2)(c) in the Act
In this context:
• a supply driven model refers to the current system where the government controls the number, funding level and location of residential aged care places and the number and level of home care packages;
• a consumer demand driven model refers to a model where once a consumer is assessed as needing care, they will receive appropriate funding, and can choose services from a provider of their choice and also choose how, where and what services will be delivered.
Response provided:
I still fail to understand exactly how this Consumer Demand Driven Model will work. I can see it in Home Care, where a person can chose from different services and different care options. In my opinion, people already have that choice with Residential Care, particularly in areas that have a number of services available. The consumer is able to choose which home to enter, and basically if they don’t feel comfortable in that home, they are able to change to another service quite readily. I am not sure what additional choices the consumer will have. Will it revolve around food and activities, or will it extend to clinical care? What will be the repercussions on a service if a resident spends their ‘allowance’ on pay TV and refused to spend anything on clinical care? I have spoken with numerous management personnel from various services, and none is convinced that CDC will work in Residential Aged Care. The first question that should be asked, is “do we need to make this change.” The ‘consumer driven model’ may work in metro areas, however I still struggle to understand exactly what the consumer is going to be able to do.
2.4 The effectiveness of means testing arrangements for aged care services, including an assessment of the alignment of charges across residential care and home care services
Refers to Section 4(2)(d) in the Act
In this context:
• means testing arrangements means the assessment process where:
- the capacity of a person to contribute to their care or accommodation is assessed (their assessable income and assets are determined); and
- the contribution that they should make to their care or accommodation is decided (their means or income tested care fee, and any accommodation payment or contribution is determined).
Response provided:
I am not involved in Home Care services, so cannot comment on that part of the question. I can say that I believe the current arrangements for Residential Care means testing are based on a fair and reasonable system. With very few exceptions, an accurate assessment delivers an affordable payment requirement within the persons capacity to pay. The problem is in the delivery of the assessments which is still riddled with errors and inconsistencies over 2 years into the new rules.
2.5 The effectiveness of arrangements for regulating prices for aged care accommodation
Refers to Section 4(2)(e) in the Act
In this context:
• regulating prices for aged care accommodation means the legislation that controls how a residential aged care provider advertises their accommodation prices.
Response provided:
The advertising of prices seems to be quite effective, if one only looks at the pricing of the room itself. It is no secret that some services are charging outrageous prices for additional service, and refurbishment fees to bring in further revenue. This effectively makes a mockery of the regulation of prices, as it is simply a means of increasing revenue in lieu of a higher room price. This has been the subject of recent bulletins from the Department, but it has not actually made a definitive ruling on these practices.
2.6 The effectiveness of arrangements for protecting equity of access to aged care services for different population groups
Refers to Section 4(2)(f) in the Act
In this context equity of access means that regardless of cultural or linguistic background, sexuality, life circumstance or location, consumers can access the care and support they need.
In this context different population groups could include:
• people from Aboriginal and/or Torres Strait Islander communities;
• people from culturally and linguistically diverse (CALD) backgrounds;
• people who live in rural or remote areas;
• people who are financially or socially disadvantaged;
• people who are veterans of the Australian Defence Force or an allied defence force including the spouse, widow or widower of a veteran;
• people who are homeless, or at risk of becoming homeless;
• people who are care leavers (which includes Forgotten Australians, Former Child Migrants and Stolen Generations);
• parents separated from their children by forced adoption or removal; and/or
• people from lesbian, gay, bisexual, trans/transgender and intersex (LGBTI) communities.
Response provided:
My area of concern is Rural and Remote Residential Aged Care. The report “Financial Issues Affecting Rural and Remote Aged Care Providers” (ACFA February 2016) concludes that services in this sector generally have higher costs and lower financial results. They receive less Government funding from Care Services (ACFI); have significantly higher expenses, particularly labour costs; and receive lower average Refundable Accommodation Deposits. According to that report, the operating profit in the study group was negative $-2,004. Per resident per annum compared with positive $8,840 in non-rural areas. This is clearly not sustainable, and has not been addressed in any realistic manner since the release of the report. Combined with the ‘tweaking’ of the ACFI funding model, there is a real fear within the industry that Rural and Remote services could become unviable in the foreseeable future. It also means that there is insufficient revenue to consider expanding a facility – even if the need is there. This could result in people having to move to major cities, far away from loved ones and friends. Conclusion: at present I do not believe the arrangements for protecting the ongoing access of Rural and Remote communities to access Residential Aged Care is effective.
2.7 The effectiveness of workforce strategies in aged care services, including strategies for the education, recruitment, retention and funding of aged care workers
Refers to Section 4(2)(g) in the Act
In this context aged care workers could include:
• paid direct-care workers including nurses personal care or community care workers, and allied health professionals such as physiotherapists and occupational therapists; and
• paid non-direct care workers including: managers who work in administration or ancillary workers who provide catering, cleaning, laundry, maintenance and gardening.
Response provided:
There has been no noticeable change at this service with regard to this topic. It is still an area with which we struggle to get suitably qualified staff, particularly nurses, and of course don’t have an availability of ‘agency’ staff to call on.
2.8 The effectiveness of arrangements for protecting refundable deposits and accommodation bonds
Refers to Section 4(2)(h) in the Act
In this context:
• arrangements for protecting refundable deposits and accommodation bonds means the operation of the Aged Care Accommodation Bond Guarantee Scheme.
Response provided:
One has to assume that they are effective. I have no personal knowledge of a situation where this has been tested. I know homes report their bonds and financial situation to the department, but I don’t know how the accuracy of the information sent is verified.
2.9 The effectiveness of arrangements for facilitating access to aged care services
Refers to Section 4(2)(i) in the Act
In this context access to aged care services means:
• how aged care information is accessed; and
• how consumers access aged care services through the aged care assessment process.
Response provided:
This has quite a way to go. The general public is confused about the changes, and don’t know where to obtain information. The ‘Income and Asset’ assessments are proving to be difficult to navigate, and are becoming more inaccurate and confusing as time goes on. We spend an inordinate amount of time trying to guide people through the requirements of the system. There was a lot of publicity around the MyAged Care contact point when the changes were first introduced, but people now seen to left to fathom it out for themselves.
3. Other comments
Response provided:
I question how this survey has been promoted to Residents, potential residents, and their families/carers etc. I suspect that very few of them have subscribed to the Department of Health – Aged Care Updates. I have not seen the survey advertised anywhere else, and I don’t know how a Resident would respond to it if they were aware of the survey. There does not appear to be any method of responding apart from online or by email which excludes the vast majority of Residential Aged Care residents from responding if they were aware of the survey.
Secondly, I question the need for this deregulation and freedom of choice in this industry. This has been done in the power and utility industry with mixed results. A number if industry publications are also questioning the success of the CDC in home care (which I don’t have any personal experience of), and whether there was really any need to change the previous system. I hope it is not another example of change for change’s sake, driven by people who are not actually either receiving or delivering the services. There seems to be a degree of idealistic proposals put forward, possibly by people who may be receiving aged care services in a number of years. With all due respect to those people, what they think they will want may not necessarily be important when they get there.
Many older people hate making decisions and choices. Do they really want this forced upon them? Do the organisers of this survey intend to actually seek the views of current residents?
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