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The Council’s response to the Royal Commission into Aged Care Quality and Safety – Consultation Paper 1

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Mr Rodger Prince
Co-Solicitor Assisting the Royal Commission
Royal Commission into Aged Care Quality and Safety

Email: ACRCProgramDesign@royalcommission.gov.au

Cc: laura.groves@royalcommission.gov.au

Dear Mr Prince

Re: Consultation Paper 1: Aged Care Program Redesign: Services for the Future

I am writing in my capacity as Deputy Chair (and currently Acting Chair) of the board of directors of the Aged Care Workforce Industry Council Limited (Council).

The establishment of the Council was one of 14 strategic actions (the Strategic Actions) recommended in the ‘Australia’s Aged Care Workforce Strategy – A Matter of Care’.

The Council seeks to lead structural change across the industry. The stated object of the Council as a legal entity is to “improve aged care in Australia by improving the Workforce to ensure that:

  • The Workforce provides aged care services that can meet the care needs of older Australians now and into the future; and
  • Older Australians have equitable access to aged care and the dignity to age well, irrespective of setting.”

Accordingly, on behalf of the Council, I am pleased to provide our brief submission in relation to the Royal Commission’s first consultation paper. Our submission demonstrates how implementation of ‘A Matter of Care’ will support the design of a new aged care system.

Acknowledging the Challenges Ahead

The foundational efforts of the Council, since its formation in May 2019, highlight the challenges ahead to bring together a fragmented industry – one that remains deeply undervalued in our community. As we established our program of work for 2020 (summarised under the section titled “Implementing A Matter of Care – Creating a Baseline for Success”), our perspectives aligned with the following observations made by the Royal Commission, which is that the aged care system:

  • Is not designed to deliver consistent equity of access
  • Does not invest enough in interventions to promote the independence, functioning and quality of life for olderpeople
  • Does not foster the provision of services that work effectively with related systems, particularly health and disability
  • Struggles to attract and retain sufficient numbers of skilled, knowledgeable and competent staff
  • Is complex and fragmented, meaning that change is difficult to achieve
  • Faces growing challenges in affordability and sustainability.

The Council also agrees with the Royal Commission’s Interim Report conclusion that the aged care system is in desperate need of redesign – not mere patching up. And to address the above in a sustainable way will require industry, government and the community to address the public perceptions of our sector, the value of both paid and unpaid carers and the volunteers who provide an invaluable social contribution.

The Council remains focussed on its remit – to implement ‘A Matter of Care’. Doing so, will go a long way to addressing the structural issues, called out by the Royal Commission. However, the Strategy represents the starting point to drive a process of transformation necessary to lead, inspire and effect lasting change.

The Council, as a leadership group of providers together with an employee nominee and consumer nominee, has a unique ability to design and test solutions to systemic issues, given their direct role in delivery. They are also well positioned to communicate learnings and drive cultural change.

Embedding long-lasting cultural change is fundamentally about inspiring people to act differently.

Implementing A Matter of Care – A Call to Action

The Council recognises that the expectation that reform can occur without a supporting infrastructure is one of the most frequent reasons why it fails. Infrastructure is needed to support the leadership, governance, and collaboration required to achieve system-wide workforce improvements.

As a leadership group, the Council needs to help guide the vision and the approach. It needs to:

  • Help people understand the system and the complexity of which they are a part
  • Foster a dialogue that leads to greater clarity, understanding of difference, and innovation
  • Shift the collective focus from reactive problem-solving to co-creation of the future.

Industry must take responsibility for the aged care workforce.

As a leadership group, the Council needs to support aligned activities. It needs to:

  • Promote a shared vision for change and a joint approach to solving workforce challenges through agreed-upon actions and approaches
  • Support mobilisation and alignment of public and private resources to support implementation goals – working in collaboration with government.

The Council is the primary vehicle to activate workforce reform.

As a leadership group, the Council needs to establish shared measurement practices. It needs to:

  • Agree a short list of common indicators to measure and report on progress, drive learning and improvement
  • Support infrastructure investment necessary to: collect, analyse, interpret, share and report across data sources (securely); in order to develop shared measurement systems and reporting capability.

Transparency is essential to embed the culture change.

Lastly, as a leadership group, the Council needs to help cultivate community engagement and ownership. It needs to focus on setting up the right communication structures in order to:

  • Create a sense of urgency (national visibility) and support calls to action across our industry leaders
  • Coordinate and facilitate continuous communication and collaboration
  • Leverage alignment with other efforts across industry, government and the community.

Without open and frequent communication there is no accountability

Implementing A Matter of Care – Creating a Baseline for Success

Best-in-class leaders unlock benefits by focusing on baseline operational matters initially and staging out a path to an ambitious transformational agenda over time.

For the Strategy to deliver more than the sum of its parts, the Council has been working to identify risks, understand dependencies and build out work streams in an agreed sequence.

The Council remains focussed on the following priorities (to 30 June 2020):

  • Workforce planningGiven the projected growth in demand for workers across the aged care sector, the Council notes the need for evidence-based, industry validated forecasts of skill demand. Of primary importance is access to quantitative workforce data that can be combined with qualitative workforce profiling.The Council (led by Council Directors Sandra Hills of Benetas and Ian Thorley of Estia Health) are working in collaboration with the Department of Health and Best Practice Australia to develop the first “Industry Workforce Study” – which will become an annual publication for the duration of the implementation of the Strategy.The Council notes the deficiencies in aged care workforce data and a lack of nationally agreed standards makes it difficult to analyse the composition of the current workforce, and how that workforce may need to develop and adjust to meet future needs. Further, they consider that the adequacy of healthcare workforce data collection needs to be addressed as a priority, in order to have complete and accurate information concerning workforce trends and needs into the future.By giving the industry access to information and benchmarks on workplace culture, there is a very powerful motivation to commit to practical and tangible improvements.
  • Voluntary Industry Code of PracticeDriving the process of transformational reform essential to lead, inspire and effect lasting change begins with a single industry voluntary code of practice (the Code). The Code embodies the intent of the Strategy and is aimed at unifying providers across the industry.The Council (led by Council Director Cathy Thomas of Blue Care) are working closely with the peak bodies, led by Leading Age Services Australia (LASA) to enable rollout of the Code.
  • Assessment and development of online training curriculum
    Online training remains a key mechanism to upskill the workforce. Currently, providers undertake their ownonline training however there is no holistic industry offering.The Council, in collaboration with the industry and the Department of Health will undertake an assessment, to inform the development of industry training and education programs that supports particularly those providers without the capacity or capability to invest in-house.
  • Supporting the establishment of the Centre for Growth and Translational ResearchThe opportunity is to translate research findings into practical actions that will positively impact on the supports available to older Australians and the broader community – at a scale and speed that can make a tangible and timely difference to their quality of life.The Council (led by Council Director John McCallum of National Seniors Australia) are working in collaboration with the Department of Health to support the establishment of the Centre for Growth and Translational Research (CGTR).It is envisaged the CGTR will provide the collaborative research ecosystem that is required to support current and future aged care organisations and their workforces. Only through the CGTR will the industry be able to make the right investments and create the right mechanisms to improve research translation.
  • Industry approach to workforce planning
    The aged care industry does not have a standard approach to workforce planning, including skills mix modelling.And workforce planning is a capability gap broadly across the industry.The Council (led by Council Director David Maher of Catholic Healthcare) will use the outputs from the preceding foundational projects to inform an industry approach workforce planning.The Council see the opportunity, as an industry, to better support each other by employing a standard approach. In so doing, to have it informed by the consumer’s care needs along with their evolving expectations. As an industry, we must define what care and good care looks like.As such providers can demonstrate that the workforce is planned and the number and mix of staff deployed enables the delivery and management of safe and quality care and services, a standard approach to the fundamental elements of workforce planning is needed.

Collectively, this baseline of work will help shape the Council’s program of work for 2020/21.

All of this is underpinned by an active culture of collaboration. The Council recognises collaboration is essential for the industry to be open to engagement with the parties that manifestly share interest in having a respected, skilled and well supported workforce.

All of this is necessary to demonstrate to those outside aged care that this industry will be one of the social and economic driving forces of the country – now and into the future.

Yours sincerely

Kevin McCoy
Deputy Chair
Aged Care Workforce Industry Council

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